HB499 Alabama 2013 Session

Summary

Primary Sponsor

Greg Wren

Republican

Session

Regular Session 2013

Title

Health Center Access and Quality Improvement Act, estab., assessment of health centers, administered by Revenue Department, fees, deposit for use by Medicaid Agency, termination date

Summary

The bill creates a Health Center Access and Quality Improvement Program funded by an assessment on Alabama qualified health centers to improve access and care for Medicaid patients, with CMS oversight and a sunset in 2016.

What This Bill Does

It imposes a licensing-style assessment on qualified health centers to fund an Alabama Health Center Access and Quality Improvement Program. The money goes into the Health Center Assessment Account to help the Alabama Medicaid Agency draw federal matching funds and support access payments, health home payments, and quality improvement payments. The program requires CMS approval of related Medicaid State Plan changes and is overseen by a six-member Health Center Services and Reimbursement Panel; it then sunsets on September 30, 2016 unless extended by later law.

Who It Affects

• Qualified health centers (FQHCs) in Alabama: subject to the assessment, eligible for access payments, health home payments, and quality improvement payments if they meet criteria and certifications.
• Alabama Medicaid Agency: administers the program, verifies net patient revenue, makes payments (access, health home, QA), and seeks CMS approval and FMAP funding.
• Department of Revenue: collects the assessment from centers and deposits to the Health Center Assessment Account.
• Alabama Primary Health Care Association: certifies eligibility and net patient revenue; convenes as part of the Health Center Services and Reimbursement Panel; represents health centers in oversight.
• Health Center Services and Reimbursement Panel: reviews and approves Medicaid State Plan amendments, waivers, or policies involving health center services or reimbursement before submission to CMS or Legislature.
• CMS (Centers for Medicare and Medicaid Services): must approve Medicaid State Plan amendments and waivers; determines FMAP availability and waivers as applicable.
• Medicaid-eligible patients served by qualified health centers: should benefit from improved access to primary and preventive care and coordinated services.

Key Provisions

• Establishes the Health Center Access and Quality Improvement Program, administered by the Department of Revenue, funded by assessments on qualified health centers, with the Alabama Medicaid Agency using funds to obtain federal matching funds.
• Imposes an assessment equal to 5.5% of net patient revenue for 2014–2016, starting October 1, 2013, limited to net patient revenues earned in Alabama, and recognized as an allowable Medicaid cost.
• Creates the Health Center Assessment Account within the Health Care Trust Fund; deposits from assessments; funds used only for access payments, health home payments, and quality improvement payments, subject to CMS approval and FMAP availability; provisions to protect funds from budget cuts where permissible.
• Allocates at least 22% of total funded expenditures to access payments, 9% to base quality improvement payments, and at least 15% to additional quality improvement payments; percentages adjust with changes in FMAP to maintain equivalent shares.
• Provides quarterly payment timing (last business days of each quarter) once CMS approvals are in place and a 30-day verification and dispute process for assessment calculations; allows refunds or adjustments if CMS waivers or approvals are not granted.
• Section 8–9: Medicaid shall reimburse health center services and health home payments separately from the Health Center Assessment Account, using Medicaid funds and state revenue, with health home payments funded from either the Assessment Account or additional state funds.
• Section 10–11: Defines access payments and quality improvement payments criteria, including thresholds related to patient coverage, income levels, minority status, chronic disease burden, and other HRSA-aligned measures; includes base and enhanced QA activities and quarterly payments; requires HRSA-aligned measures and performance standards.
• Section 13 establishes the Health Center Services and Reimbursement Panel (six members) to approve Medicaid State Plan amendments and waivers before submission to CMS or the Legislature; panel includes Medicaid Commissioner, Governor-appointed health center representatives, and leadership appointments; ensures diversity and regional representation.
• Section 12 and Section 14 provide conditions under which the assessment may cease (e.g., CMS approval failure, FMAP unavailability, or constitutional issues) and require refunding any remaining funds; non-severability ensures the whole act terminates if any part is invalid.
• Section 15 sets the act to take effect upon passage and gubernatorial approval (or standard law process) and auto-terminates on September 30, 2016 unless extended by future legislation.

AI-generated summary using openai/gpt-5-nano on Feb 24, 2026. May contain errors — refer to the official bill text for accuracy.

Subjects

Health