New Medicaid districts divided into five regions across the stateBy Emily Etheredge Published 4:41pm Friday, July 5, 2013
The official notice of five new Medicaid districts was published with the state of Alabama in an effort to streamline the system.
Earlier this year, the Alabama Legislature approved a reorganization of Medicaid into districts around the state, including Chilton County.
Counties included in the five regions are:
Region A: Lauderdale, Limestone, Madison, Jackson, Colbert, Franklin, Laurence, Morgan, Cullman and Marshall.
Region B: DeKalb, Etowah, Cherokee, Calhoun, Cleburne, Clay, Randolph, Tallapoosa, Blount, Walker, Jefferson, St. Clair, Shelby, Talladega and Coosa.
Region C: Chilton, Autauga, Elmore, Chambers, Lee, Macon, Russell, Bullock, Dallas, Lowndes, Montgomery, Macon, Butler, Crenshaw, Pike, Barbour, Coffee, Dale, Geneva, Houston and Henry.
Region E: Washington, Mobile, Baldwin, Monroe, Clarke, Conecuh and Escambia.
Communications director of the Alabama Medicaid Agency Robin Rawls said the Medicaid form is a detailed process that started with the approval of the Alabama Senate on April 25 and later in the House of Representatives on May 7.
The map of the new districts will be finalized on Oct. 1, 2013, and regional care organizations would have to be ready to sign contracts no later than Oct. 1, 2016.
Rawls said the proposed district map with the five regions will allow one new organization in each region to receive a monthly payment from Medicaid to provide health care for Medicaid recipients in its region.
According to Rawls, Medicaid patients are encouraged to get their health care from facilities within their districts but they are not required to do so.
“Currently, the system is where Medicaid pays doctors and hospitals for each act of patient care,” Rawls said. “This is typically referred to as fee-for-service.
Rawls said the purpose of the change from the fee-for-service approach is largely due to the cost of Medicaid that takes up a third of the state’s General Fund.
“The legislature introduced this to stabilize the funding that goes toward Medicaid,” Rawls said.
Rawls said some of the counties in the districts could be shifted before Oct. 1.
Gov. Robert Bentley appointed the Alabama Medicaid Advisory Commission to improve Medicaid’s financial stability while also providing high-quality patient care. The commission recommended in January that Alabama be divided into regions, and that a community-led network coordinate the health care of Medicaid patients in each region, with networks bearing the risks of contracting with Alabama to provide that care.
Medicaid will enter into contracts with regional care organizations that will provide services for patients at an established cost.
Rawls said when the regions were being divided geographically, Chilton County was ultimately decided for Region C due to most of the referral areas from Chilton County traveling to Prattville and Montgomery.
The new district plan will now enter into a public comment period for the next 35 days where people can give input on whether they think the changes need to be made.
Rawls encouraged anyone who might like to have input to attend a public hearing set for July 15 in the State Capital Auditorium in Montgomery.
“The public hearing portion is a good way to hear from anyone who might have any ideas as far as the districting goes,” Rawls said. “We would love to hear from anyone who might have an opinion on this.”
Rawls said anyone wishing to make a public comment via e-mail can contact Stephanie Lindsay in the Alabama Medicaid Administrative Procedures office, at firstname.lastname@example.org.