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TO: Participating Alabama Coordinated Health
Network Primary Care Physician Groups
RE: Fiscal Year (FY) 2023 (October 1,
2022-September 30, 2023) Patient-Centered Medical Home (PCMH) Attestation
Alabama Medicaid Primary
Care Physician (PCP) Groups actively participating with an Alabama Coordinated
Health Network (ACHN) may be eligible to receive a quarterly Patient-Centered
Medical Home (PCMH) Bonus Payment. The PCMH Bonus is 5% of the entire annual
ACHN bonus pool of $15 million dollars. The PCMH Bonus will be based on actual
achievement of or progress towards achievement of PCMH Certification through a
nationally recognized entity such as the National Committee for Quality
Assurance (NCQA), the Joint Commission, or the Compliance Team, amongst others.
Attestation for this certification must be received annually by the Agency no
later than October 1st to ensure eligibility for the PCMH Bonus for
the upcoming fiscal year.
Note: The PCMH Bonus is optional. PCP Groups may
still be eligible to receive the quality and cost effectiveness bonus payments
if they choose not to participate in the PCMH Attestation process.
Below is the Alabama
Medicaid Agency’s PCMH Bonus Attestation process:
1.
Effective with FY 2021, PCMH Bonus payments are paid ONLY to PCP Groups
who have achieved or working towards achieving PCMH Certification from a
nationally recognized certifying entity (e.g. NCQA, the Joint Commission, the
Compliance Team, etc.).
2.
ALL PCP Groups interested in receiving the 5% PCMH Bonus payment must
attest to the Agency. This includes PCP
Groups who have achieved or made progress towards PCMH Certification through
NCQA.
3.
Attestation must be received annually by the Agency no
later than October 1st. The attestation will be valid
for one year.
4.
PCP Groups can begin submitting their attestation for FY 2023 now.
PCP Groups that have not
received PCMH Recognition but have made adequate progress towards PCMH
Recognition may be eligible to receive the PCMH Bonus. PCP Groups that have
made adequate progress must complete and submit the PCMH Attestation Form and
supporting documentation showing adequate progress with their certifying
entity. Refer to Chapter 40, Section 40.20 of the most current version of the
Alabama Medicaid Provider Manual for definitions of adequate progress for each
certifying entity.
To be eligible for the PCMH Bonus, PCP Groups should
adhere to the following protocol:
1.
Obtain PCMH Recognition or make adequate progress. PCMH Recognition is a
separate process from attestation. PCP Groups must contact the national
certifying entity from which they wish to receive recognition and make progress
or complete the PCMH Certification process. The Agency cannot assist with the
PCMH Certification process nor recommend a certifying entity to PCP Groups.
Note: It is imperative that PCP Groups begin the
PCMH Certification process with their certifying entity as soon as possible to
avoid tardy attestation to the Medicaid Agency. The Agency will not accept
attestations after the October 1st deadline.
2.
Attest to the Medicaid Agency. After receiving PCMH Certification or
making adequate progress from the national certifying entity, the PCP Group
must attest (via PCMH Attestation Form) to the Agency no later than October 1st
to receive PCMH Bonus eligibility for the upcoming fiscal year (e.g. to receive
PCMH Bonus eligibility for FY 2023, the attestation form and supporting
documentation must be received by October 1, 2022). The Agency will not accept
attestations after the October 1st deadline.
3.
Receive notification. PCP Groups who attest to the Agency will be
notified of their PCMH Bonus eligibility status via mail and/or e-mail.
4.
Remember to attest every year. PCP Groups that wish to continue to receive
the 5% PCMH Bonus must attest annually no later than October 1st.
The PCMH Attestation Form
can be found here: https://medicaid.alabama.gov/content/9.0_Resources/9.4_Forms_Library/9.4.19_ACHN_PCP_Forms.aspx
For questions related to the PCMH Attestation process,
e-mail ACHN@medicaid.alabama.gov.
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