Ala. Admin. Code r. 560-X-7-.26
Medicare/Medicaid Eligible Recipients
Effective Jan 11, 1996Rule effective October 1, 1982. Amended effective October 9, 1984; March 7, 1986; April 11, 1986; September 8, 1986; January 1, 1988. (Ed. Note: Previously Rule No. 560-X-7-.27.) Emergency rule effective February 1, 1989. Amended effective May 12, 1989. Amended: Filed December 6, 1995; effective January 11, 1996.Alabama Medicaid Agency
- (1) Inpatient - Refer to Rule 560-X-1-.14 for details.
- (2) Outpatient-Part B. Payment for outpatient crossover claims shall be based on the lesser of the coinsurance and/or deductible amount or the Medicare allowed amount times the outpatient percentage rate minus the Medicare paid amount.
Author: Cecil Martin, James V. Harris, Ruth H. Chambliss, Vicki W. Huff
Statutory Authority: State Plan, Attachment 3.1-A, 3.2-A; 42 C.F.R. §§409.60, .80, .83; Medicare Catastrophic Coverage Act of 1988 (Public Law 100-360).
History: Rule effective October 1, 1982. Amended effective October 9, 1984; March 7, 1986; April 11, 1986; September 8, 1986; January 1, 1988. (Ed. Note: Previously Rule No. 560-X-7-.27.) Emergency rule effective February 1, 1989. Amended effective May 12, 1989. Amended: Filed December 6, 1995; effective January 11, 1996.