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TO:  Participating Alabama Coordinated Health Network Primary Care Physician Groups

Beginning with the January 22, 2021 checkwrite, the Alabama Medicaid Agency will set aside funds from the annual Alabama Coordinated Health Network (ACHN) bonus payment pool. The reserved funds will assist with the unforeseen situations that would cause the Agency to recoup and redistribute the bonus pool. The Agency will reserve a total of $400,000 from the annual $15 million bonus pool. This is equivalent to a reserve of $100,000 per quarter. 

If a Primary Care Physician (PCP) group(s) is inaccurately paid due to miscalculation(s) or inadvertently omitted from the bonus payment distribution, the Agency will use the reserve funds to pay the PCP group(s). In addition, if funds are recouped from a PCP group, the recouped amount will be added to the reserve funds. During the last quarter of the fiscal year, the Agency will distribute any remaining reserve funds to actively participating ACHN PCP groups.

DIAGRAM: Annual $15 Million Bonus Payment Pool

NOTE: Because the reserve funds will go into effect during the second quarter, the Agency will reserve a total $300,000 for FY 2021. For subsequent years, the Agency will reserve the standard $400,000 annually.

Other important facts:

• The bonus pool amount is not changing; PCP groups will be made whole at the end of the fiscal year.
• Active participation with the ACHN is still required to qualify for the bonus payments.
• The presented changes will not affect the bonus payment calculation schedules.
• PCP groups are not required to take any necessary actions related to the presented changes.
• The ACHN bonus payment will continue to be distributed on the second checkwrite of the first month of the quarter.
• The presented changes will not affect the enhanced ACHN participation rates.
• The presented changes will not affect the Delivering Healthcare Professional (DHCP) bonus payments.
  

For questions related to the ACHN bonus payment changes, you may e-mail ACHN@medicaid.alabama.gov.

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