Ala. Admin. Code r. 560-X-11-.05
Providers Of Screening Services
Effective May 15, 2026Rule effective October 1, 1982. Amended: Effective May 9, 1984; July 9, 1984. Emergency rule effective December 1, 1986. Amended: Effective March 12, 1987; July 13, 1989. Emergency rule effective October 1, 1990. Amended: Effective February 13, 1991, Filed April 5, 1995, effective May 11, 1995. Amended: Filed November 6, 1996; effective December 12, 1996. Amended: Filed April 5, 1999; effective May 10, 1999. Amended: Published March 31, 2026; effective May 15, 2026.Alabama Medicaid Agency
- (1) In-state and borderline out-of-state (within 30-mile radius of state line) health care agencies and physicians wishing to participate in the EPSDT Program may request enrollment information from the Alabama Medicaid Agency. Exception: The Fiscal Agent will be responsible for enrolling any Title XVIII (Medicare) providers that wish to enroll as a QMB-only provider.
- (2) All providers of screening services must enter into an agreement with Alabama Medicaid Agency to participate in the EPSDT Program as a screening provider. Exception: QMB-only providers. Each off-site location will require a separate application, a separate contract, and will be assigned a provider number distinct from any other the provider may have with Medicaid.
- (3) All health care agencies enrolled shall be under the direction of a duly-1icensed physician, a currently licensed registered nurse, certified registered nurse practitioner, or a physician assistant who shall be responsible for assuring that requirements of participation are met and that the procedures established by the Medicaid program are carried out.
- (4) Screening programs conducted under the direction of a registered nurse or certified nurse practitioner must have a licensed physician acting as medical consultant.
- (5) EPSDT services may be offered by School-Based screening providers.
Author: Daniel Bankson, Program Manager, EPSDT and Physicians Programs, Health Services Division
Statutory Authority: Title XIX, Social Security Act; State Plan; 42 C.F.R. Section 400.203, Section 441.56. Medicare Catastrophic Coverage Act of 1988 (Public Law 100-360). OBRA
'89-Section 6403.
History: Rule effective October 1, 1982. Amended: Effective May 9, 1984; July 9, 1984. Emergency rule effective December 1, 1986. Amended: Effective March 12, 1987; July 13, 1989. Emergency rule effective October 1, 1990. Amended: Effective February 13, 1991, Filed April 5, 1995, effective May 11, 1995. Amended: Filed November 6, 1996; effective December 12, 1996. Amended: Filed April 5, 1999; effective May 10, 1999. Amended: Published March 31, 2026; effective May 15, 2026.