1. (1) Medical care and services provided outside the State of Alabama for Alabama Medicaid recipients are covered services if and only if such services are covered when rendered in state and are medically necessary.

   1. (a) Medical care and services which require prior authorization for in-state providers will continue to require prior authorization for out-of-state providers.
   2. (b) Out of state providers must follow the enrollment procedures of the Alabama Medicaid Agency.

Author: Kathy Hall, Deputy Commissioner, Program Administration

Statutory Authority: State Plan; Social Security Act, Title XIX, §§1902(a)(16), 1902(a)(10)(A); 42 C.F.R. §431.52.

History: Rule effective October 1, 1982. Amended: Effective October 13, 1992. Amended: Filed September 11, 2013; effective October 16, 2013.