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Alabama Medicaid

(VM043)
Monday, October 25, 2021
Attention all Providers submitting a PA (NOT pharmacy, dental, or radiology PAs): Effective October 1, 2021, please contact the new PA vendor Kepro with questions related to a submitted PA at (800) 426-7259 or (800) 472-2902. The process for submitting PA requests to Gainwell Technologies remains the same.

Attention all Hospice, Nursing Home, ICF-IID, PEC and Swing Bed Records: Effective October 1, 2021, Hospice Recipient Status Change (Form 165B) and LTC Request for Action (Form 161B) should be faxed to Kepro at (833) 536-2134 or (833) 536-2136. For questions related to any Long-Term Care reviews on or after October 1, 2021, providers should contact Kepro at (800) 426-7259 or (800) 472-2902.

The Alabama Medicaid Agency is aware of a reimbursement recoupment from some providers on the 9/10/2021 check write for COVID-19 testing. This action was triggered by retroactive application of a change in the Medicare rate. A reversal of the 9/10/2021 recoupment is to be included in the 10/01/21 check write with repayment to providers occurring on or before October 12, 2021. We are reviewing the testing reimbursement rates and will provide advance notice if additional changes will be required. We apologize for the inconvenience.

At the onset of the COVID-19 pandemic, Medicaid temporarily ceased revalidation for providers. Medicaid has now resumed revalidation for providers. Affected providers may contact the Gainwell Provider Enrollment Unit at 1-888-223-3630 and speak to a Provider Enrollment Specialist. To learn more about the revalidation process please visit https://medicaid.alabama.gov, select the 'Providers' Tab, then click on the 'Provider Enrollment' Link to view details.

All previously published expiration dates related to the Coronavirus (COVID-19) emergency are once again extended by the Alabama Medicaid Agency. The new expiration date is the earlier of October 31, 2021, the conclusion of the COVID-19 National emergency, or any expiration date noticed by the Alabama Medicaid Agency through a subsequent ALERT. A listing of previous Provider ALERTs and notices related to the health emergency is available by selecting the Agency's COVID-19 page in the bottom section: https://medicaid.alabama.gov/news_detail.aspx?ID=13729
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