(a) For the purposes of this section, the following words have the following meanings:
(1) COUNTY INMATE. Any person being held in a public institution under the administrative control and responsibility of the county sheriff and for whom the county is responsible for the provision of medical care. The term includes a person in custody while awaiting arraignment or bond, a pretrial detainee, a convicted person who is awaiting transfer to but has not otherwise become the responsibility of the Department of Corrections, or a person serving his or her sentence in the county jail.
(2) INPATIENT. This term as defined in 42 C.F.R. § 435.1010, as may be amended.
(3) JUVENILE. Any child under the jurisdiction of the juvenile court who is detained in a public institution and for whom the county is responsible for the provision of medical care pursuant to Section 12-15-108.
(4) MEDICAL INSTITUTION. This term as defined in 42 C.F.R. § 435.1010, as may be amended.
(b)(1) A county inmate shall have his or her Medicaid benefits suspended, but not terminated, provided he or she is otherwise eligible for Medicaid benefits. Suspension of benefits under this subdivision shall continue until the county inmate is either no longer otherwise eligible for Medicaid or is no longer an inmate of a public institution.
(2) A juvenile shall have his or her Medicaid benefits suspended, but not terminated, provided he or she is otherwise eligible for Medicaid benefits. Suspension of benefits under this subdivision shall continue until the juvenile is either no longer otherwise eligible for Medicaid or is no longer detained in a public institution.
(c) Any county inmate or juvenile who meets the conditions set out in subsection (b) shall be eligible for reinstatement of Medicaid benefits for medical care received as an inpatient in a medical institution, provided he or she is otherwise eligible for the Medicaid benefits. The county commission or other governmental entity financially responsible for the county inmate or juvenile shall reimburse the Medicaid Agency for the full amount of any federally required state match due for the inpatient services provided to any person whose Medicaid benefits are reinstated pursuant to this subsection.
(d) In order to determine whether a county inmate or juvenile meets the criteria set out in subsection (b) and to properly process suspension and reinstatement of Medicaid benefits as provided for in this section, the Medicaid Agency and the Association of County Commissions of Alabama shall develop, approve, and implement a centralized process for dissemination of information between the Medicaid Agency and each county. The approved process may include participation by the Association of County Commissions of Alabama in providing information to the Medicaid Agency on behalf of the counties. The centralized process shall be developed, approved, and implemented not later than November 1, 2017, and the participating county commissions shall reimburse the Medicaid Agency for the full amount of any federally required state match incurred to establish the centralized process. The centralized process, at a minimum, shall include all of the following:
(1) A process for each county to identify county inmates and juveniles who are Medicaid recipients at the time they are taken into custody.
(2) A process for notifying the Medicaid Agency when the Medicaid benefits of a county inmate or juvenile are due to be reinstated for inpatient services because the county inmate or juvenile is receiving inpatient care in a medical institution.
(3) A process for the county commission or other responsible governmental entity to reimburse the Medicaid Agency for the full amount of any federally required state match due for the inpatient services provided to a county inmate or juvenile whose Medicaid benefits for inpatient services are reinstated under this section.
(4) A process for the county commission to notify the Medicaid Agency when the county inmate is no longer an inmate of a public institution under the administrative control and responsibility of the county sheriff.
(5) A process for the county commission to notify the Medicaid Agency when the juvenile is no longer detained in a public institution.
Last modified: May 3, 2021