Quarterly DME Updates
Jul 8, 2025 - Effective June 1, 2025, the Alabama Medicaid Agency updated the incontinence supply criteria.
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Rate Increase for EPSDT Periodic Evaluation and Management (E&M) Procedure Codes
Jun 23, 2025 - Effective July 1, 2025, the Alabama Medicaid Agency (Medicaid) will increase the reimbursement rates for certain EPSDT Periodic Evaluation and Management (E&M) procedure codes.
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Transforming Maternal Health (TMaH) Model
Jun 18, 2025 - In January 2025, the U.S. Department of Health and Human Services (HHS) through the Centers for Medicare & Medicaid Services (CMS) awarded the Alabama Medicaid Agency (Medicaid) funding to enhance maternal health and birth outcomes for pregnant and postpartum women, as well as their infants. Alabama was one of 15 states to receive the grant as part of the new Transforming Maternal Health (TMaH) Model.
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Preferred Drug List (PDL) and Pharmacy Quarterly Update
Jun 16, 2025 - Effective July 1, 2025, the Alabama Medicaid Agency (Medicaid) will: Continue to monitor the stimulant shortage affecting ADHD medications. Require PA for buprenorphine/naloxone sublingual film. Brand Suboxone will become non-preferred. Require PA for generic dapagliflozin. Update the PDL to reflect the quarterly updates listed below:
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