TO: Participating Alabama Coordinated Health Network Primary Care Physician Groups
RE: Fiscal Year (FY) 2024 (October 1, 2023-September 30, 2024) 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. 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 chose not to participate in the PCMH attestation process.
Below is the Alabama Medicaid Agency’s PCMH bonus attestation process:
- 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.).
- 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.
- Attestation must be received annually by the Agency no later than October 1st. The attestation will
be valid for one year.
- PCP Groups can begin submitting their attestation for FY 2024 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:
- 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 2024, the attestation form
and supporting documentation must be received by October 1, 2023). 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.
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