PDF Version
TO:
Participating Alabama Coordinated Health Network Primary
Care Physician Groups
RE: Fiscal Year (FY) 2027 (October
1, 2026-September 30, 2027) 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 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, among 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 (Medicaid’s) PCMH bonus attestation process:
1. 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 PCMH Bonus payment must attest to Medicaid regardless of the
nationally recognized certifying entity used to achieve or make progress
towards PCMH Certification
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 2027 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, of the most current version of the Provider Manual for definitions of
adequate progress for each certifying entity.
You may access the Provider Manual
at https://medicaid.alabama.gov/content/Gated/7.6.1G_Provider_Manuals.aspx.
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. Medicaid 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 Medicaid. The Agency will not
accept attestations after the October 1st deadline.
2. Attest to Medicaid. After receiving PCMH
certification or making adequate progress from the national certifying
entity, the PCP Group must attest (via PCMH Attestation Form) to Medicaid
no later than October 1st to receive
PCMH Bonus eligibility for the upcoming fiscal year (e.g., to receive
PCMH Bonus eligibility for FY2027, the attestation form and supporting
documentation must be received by October 1, 2026). Medicaid will not accept
attestations after the October 1st deadline.
3. Receive notification. PCP Groups who attest
to Medicaid will be notified of their PCMH bonus eligibility status via
mail and/or email.
4. Remember to attest
every year. PCP Groups that wish to continue to receive the PCMH bonus must attest annually no later
than October 1st.
The PCMH Attestation Form can be
found at 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,
email ACHN@medicaid.alabama.gov.
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