Alabama Medicaid Agency

Authorities:

Alabama. Department of Public Health. Medical Services Administration. Annual Report, 1975-1976.

Alabama. Medical Services Administration. Annual Report, 1976-1977.

Alabama. State Department of Pensions and Security. Annual Reports. 1965-1966, 1966-1967, 1967-1968, 1968-1969.

Alabama Government Manual, 1982.

Code 1975, 22:6:1-9.

The Alabama Medicaid Agency, renamed from the Medical Services Administration in 1980, was established for the administration of Title 19 of the Social Security Act. This program, according to the State Plan for Medical Assistance, pays for certain medical expenses for needy persons who meet criteria in such categories as the aged, blind, disabled, and families with dependent children. (Acts 1980, No. 80-798 [Senate Joint Resolution 54] pp. 1631-1632; James Executive Order 38, 1981)

The Agency consists of a Commissioner, appointed by the Governor and responsible to the Governor for a description of the duties of the office, two Deputy Commissioners, and four Directors. The actual processing and payment of claims for services from providers is contracted to a fiscal intermediary, an organization skilled in automated claims processing using a Medicaid Management Information System. The Agency is funded by an approximate ratio of 70% federal to 30% state funds (Ala. Government Manual, 1982).

The Agency was initially established as part of the State Department of Pensions and Security by the Executive Order of Governor George C. Wallace in 1965. Under the Bureau of Public Assistance, Medical Assistance, according to annual reports, in fiscal year 1966, general proposals were being developed toward a plan to administer Title 19 to include services required by 1967 July 1. Responsibility for Title 19 was vested in the Department of Public Health in 1966-1967. The Department of Pensions and Security would cooperate with that agency in formulating plans for the new program. In fiscal 1968 the Department of Public Health would administer the program. The State Department of Pensions and Security would be responsible for determining eligibility. Since the medicaid program provided skilled nursing care only, the Department of Pensions and Security would continue to provide intermediate care. Title 19 would have to be implemented by 1970 or the state would lose federal funds. The Department of Pensions and Security worked closely with the State Health Department and the federal Social Security Administration in the 1968-1969 year. The Department of Pensions and Security would determine financial eligibility and furnish lists of eligibles to the Department of Public Health, and both agencies would exchange data with the Social Services Administration. The State Department of Pensions and Security would provide intermediate care and other services not covered by Medicaid.

Executive Order 8 by Governor Lurleen B. Wallace in 1967 placed the duty in the Bureau of Medical Services of the Department of Public Health. It was renamed the Medical Services Administration. According to the annual report for fiscal 1975-1976, the detail work in determining eligibility was handled by outside contractors. The U.S. Social Security Agency and the State Department of Pensions and Security determined medical eligibility.

Governor George C. Wallace's Executive Order 81 in 1977 established the Medical Services Administration as a separate agency under the Governor's Office. The Medical Care Division of the State Department of Pensions and Security was transferred to the administration.

Renamed the Medicaid Agency in 1980, it is organized into the following elements:

Alabama. Medicaid Agency. Data Management.

Authority: Alabama Government Manual, 1982.

Alabama. Medicaid Agency. Fiscal Affairs.

Alabama. Medicaid Agency. General Support Services.

Alabama. Medicaid Agency. Professional Services.

Alabama. Medicaid Agency. Program Integrity.

Alabama. Medicaid Agency. Programs and Benefits.