Proposes to allow the Alabama Medicaid Agency to enter into value/outcome(s) based agreements with drug manufacturers for purpose of collecting additional supplemental drug rebates

update the home health services fee schedule by increasing the rates by one percent (1 %) for Health Care Procedural Coding System (HCPCS) codes Tl00 4 (Services of a qualified nursing aide, up to 15 minutes) and Tl021 (Home Health aide or certified nurse assistant, per visit) provided by licensed home health agencies.

Increases nursing facility Medicaid per diem rates by $13.2 million over state fiscal year 2019 rates and includes a performance rate add-on for nursing facilities scoring at or above certain metrics

Alows the state to comply with the Medicaid Drug Utilization Review (DUR) provisions included in Section 1004 of the Substance Use-Disorder Prevention that promotes Opiod Recovery and Treatment (SUPPORT) for Patients and Communities Act.

Includes Drug Utilization Review (DUR) edits relating to opiod fills and other requirements of Section 1004 of the SUPPORT Act.

The amendment to the State Plan change the language of the limitation on speech therapy rehabilitative services. Rehabilitative services will be limited unless additional services are determined to be medically necessary. This yearly limit will be based on the calendar year (January 1 through December 31). Clients under 21 in the health check services program (EPSDT) are not benefit limited.

Amends the date of the fee schedules effective January I, 2020 to update Medicare fees, additions, deletions, or changes to procedure codes when Medicare releases and updates their fee schedule. Fee schedule updates for the following services will remain budget neutral: Other Laboratory and X-Ray; Physicians; Free Standing Birthing Centers: Licensed Direct Entry Midwifes; Denturists; Dental Hygienists; Dentures; Dental; and Transportation.

SPA modifies Attachment 4.19-D of the Medicaid State Plan to freeze the rates for private intermediate care facilities for individuals with intellectual disabilities (lCF/llDs) for the state fiscal years.