CurrentAlabama MedicaidPolicy 560-X-52-.16
Home and Community‑Based Living at Home (LAH) Waiver — Application Process and Coverage Criteria
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Governance of Alabama Medicaid's LAH (Living at Home) HCBS waiver program detailing authority, purpose, service descriptions, provider requirements, and settings requirements for individuals with intellectual disabilities aged 3 and above who would otherwise require ICF/IID care.
Policy Summary
PayerAlabama Medicaid
PolicyHome and Community‑Based Living at Home (LAH) Waiver — Application Process and Coverage Criteria
Policy CodePolicy 560-X-52-.16
Change TypeTechnical / non‑material update
Effective DateAug 14, 2025
Last ReviewJun 30, 2025
Next Review DateN/A
Key ActionComplete and transmit the LTC Admissions Notification Form electronically upon receipt of the financial award letter to authorize service start and billing.
SourceLink
POLICY UPDATE CHANGES
No material clinical or coverage changes in this revision.
ages 3+eligible participant age minimum
50 hrsPT/OT initial plan limit
5 hrs/dayDay Habilitation max/day
15-minstandard billing unit
$5,000Env. Adaptations cap
$58,000Annual per-client cap
Coverage and Eligibility Criteria
LAH Waiver coverage criteria (partial doc)
General coverage and eligibility rules:
Participant must be Medicaid-eligible under the waiver and would otherwise require ICF/IID level of care.
Restricted to individuals with a diagnosis of intellectual disability, age 3 and above, and not residing in a group home; priority given to verified waiting list.
Services must be provided in HCBS-compliant community settings and cannot be provided in excluded institutional settings (e.g., nursing facilities, IMDs, ICF/IID, hospitals).
Each individual HCBS must be necessary to prevent institutionalization to qualify for Medicaid reimbursement.
Providers must have a signed provider contract, meet provider qualifications, and comply with applicable state and federal laws and regulations; services reimbursable through EPSDT shall not be reimbursed as HCBS under the LAH Waiver.
Coverage criteria for LAH Waiver services
Services under the LAH Waiver are covered when documented in the approved person-centered care plan, medically necessary to avoid institutionalization, and meet specific provider, documentation, and limit requirements.
Physical Therapy: requires a physician's prescription, an initial assessment and a documented treatment plan with established goals in the case record; providers must maintain a service log and the physical therapist must document and sign each treatment note (e-signatures allowed if meeting privacy/security requirements); services billed in 15-minute units; initial plan limited to no more than 50 hours (200 units).
Positive Behavior Support Services: require functional behavior analysis and development of a Behavior Support Plan (BSP); behavior management plans may only be used after positive behavioral approaches have been tried and must be reviewed and re-justified in the case record every 30 days; unit of service is 15 minutes; provider qualifications and supervision vary by level and annual unit limits apply (see limits).
Personal Care Services: cover ADLs and IADLs, may include general supervision and protective oversight; a written description of the worker's duties must be submitted as part of or in addition to the approved person-centered care plan and require Division approval; services are billed in 15-minute units and must not duplicate other services.
Environmental Accessibility Adaptations: provided per the person-centered plan to ensure health, safety, or independence, must meet applicable building codes and service rules; total costs are limited to $5,000 per waiver year per recipient; self-directed adaptations only available to participants self-directing personal care and/or LPN/RN services.
Specialized Medical Supplies and Assistive Technology: supplies must be authorized by the waiver recipient's physician (verbal/written orders for nonprescription assistive technology items), meet applicable standards, be documented by the operating agency, and are subject to annual caps (Specialized Medical Supplies up to $2,400 per recipient per year; Assistive Technology capped per applicable rule).
Community Specialist Services: time-limited, task-specific services requiring providers to meet QIDP qualifications, avoid duplication with case management, delivered in 15-minute units, and typically limited in duration (commonly 30–60 days; may be authorized up to 90 days per waiver year).
Respite Care: available in- or out-of-home with limits (see limits), and relatives may serve as self-directed respite workers only under specified conditions (not legally responsible, not primary caregiver, qualified, and not the employer of record).
Transportation: transportation between habilitation/service sites is included as a component of habilitation services and accounted for in the service rate; supported employment transportation may be provided when required to support work-related travel but not for mere transport.
Individual Directed Goods and Services: purchases must be cost-effective, directly beneficial to goals in the person-centered plan, not illegal, documented, and subject to individual annual purchase limits (see limits).
Eligibility and financial criteria
Medical and financial eligibility rules for LAH Waiver HCBS.
Medical eligibility: individuals must meet ICF/IID level of care; HCBS under LAH Waiver are not provided to recipients residing in institutional facilities, those with a primary diagnosis of mental illness, or those whose health and safety are at risk in the community.
Financial eligibility: limited to individuals receiving SSI; SSI-related protected groups deemed eligible for SSI/Medicaid (e.g., Widow/Widower, Disabled Adult Child, Continuous Medicaid); Parent and Other Caretaker Relatives (POCR); federal and state adoption subsidy individuals; and special HCBS waiver disabled individuals with income not greater than 300% of the SSI Federal Benefit Rate.
Applicants found eligible shall not be required to apply income above the personal needs allowance reserved to institutional residents toward payment of care.
Service components and limits
Descriptions of covered Community Specialist Services and component requirements.
Goods and Services purchases: individually determined based on the balance of the waiver recipient's savings account maintained by the Financial Management Services Agency and may not exceed $10,000 annually.
Assistance in Community Integration and Housing Stabilization Services: provided in the home or community, include assessment, assistance finding and securing housing, securing supporting documents and deposits, individualized planning, participation in person-centered plan meetings, landlord/property communication supports, and interventions to preserve or relocate housing when at risk.
Community Experience Services: covered non-work activities outside the residence to develop or use adaptive skills; staffing ratios and behavioral assessments determine whether services are approved and group sizes (up to 4) or individual 1:1 staffing as appropriate.
Supported Employment Transportation: may be provided when needed to support work-related travel and cannot be reimbursed for mere transportation; transportation may be arranged via public or private carriers.
Remote Support Services and PERS: Remote Support covered for recipients age 18 and over and must provide real-time two-way communications by awake remote staff; PERS may include installation, monthly fees, upkeep, and cellular options with required privacy safeguards and informed consent.
Provider qualifications for review team
Minimum qualifications for professionals serving on the medical review team.
ONE OF
- Nurse: graduate of a licensed school of nursing with current state certification as an LPN or RN; knowledge and training in intellectual disabilities; minimum two years' nursing experience.
- Social Worker: four-year college graduate with an emphasis in social work; knowledge and training in intellectual disabilities; minimum two years' social work experience.
- Psychologist: Ph.D. in Psychology; licensed psychologist with knowledge of test instruments for individuals with intellectual disabilities; minimum two years' experience in psychology.
- Other disciplines as necessary: may include special education, speech pathologist, audiologist, physical therapist, optometrist, occupational therapist, vocational therapist, recreational specialist, pharmacist, MD, psychiatrist, and other skilled professionals as necessary.
LAH waiver application and authorization criteria
Operational criteria for application, level-of-care, and service initiation:
Alabama Medicaid provides the operating agency with the approved Level of Care determination process.
The operating agency reviews medical eligibility; the target case manager assists with financial application and ensures appropriate documents are routed to the Medicaid District Office; financial eligibility must be certified by Medicaid.
The Waiver Coordinator completes the level-of-care determination and the case manager develops the plan of care; the operating agency must ensure screening/assessment that waiver services meet community needs and adhere to federal/state guidelines.
ADMH is responsible for assessment, admissions, readmissions, and annual redeterminations for eligible participants and may consult Medicaid staff on questionable cases.
Alabama Medicaid conducts monthly retrospective random-sample reviews to determine appropriate admissions and annual redeterminations and will initiate recoupment when medical necessity or eligibility requirements are not met; Waiver QA Unit conducts annual random samples of plans of care.
Upon receipt of the financial award letter, the LTC Admissions Notification Form must be completed and transmitted electronically to Medicaid's Fiscal Agent; an accepted transmission writes information to the Level of Care file and authorizes service start and billing; rejected transmissions must be corrected and retransmitted.
Only authorized Medicaid staff can change an individual's information once added to the Level of Care file; Medicaid may seek recoupment from ADMH if eligibility was certified improperly by ADMH.
Billing, Units, and Service Limits
Therapy unitization and limitsmixedCovered
| Occupational and Physical Therapy billed in 15-minute units; limited to an initial plan maximum of 50 hours (200 units). |
Speech therapy billing and age limitationmixedCovered
| Speech and Language Therapy Services billed as encounter units; limited to waiver recipients age 21 and over when covered under the waiver (under 21 covered by EPSDT/state plan). |
Behavior support code groupingmixed
| Positive Behavior Support Services have three provider levels (two professional, one technical) with separate procedure codes and rates; unit of service is 15 minutes. |
Time-based billing unitsmixed
| Many waiver services (including Physical and Occupational Therapy and Positive Behavior Support) are billed in 15-minute units; Skilled Nursing is billed hourly. |
Payment codingmixed
| HCPC | Payment is based on the number of units of service reported for each HCPC code and the rate in effect on the date of service. |
Enrollment and level-of-care processesmixed
| No codes listed |
Day Habilitation duration limit — 5 hours per day
LimitDay Habilitation Services cannot exceed 5 hours per day.
Setting noteFurnished in community settings (not residence) and must comply with HCBS Settings Rule.
Billing implicationTransportation between habilitation sites is included in service rate or arranged separately as specified.
Therapy initial plan limit — 50 hours / 200 units
Initial plan maximumOccupational and Physical Therapy: limited to 50 hours (200 units) for the initial plan.
UnitizationTherapies must be provided and billed in 15-minute units.
DocumentationRequires physician prescription, initial assessment, and treatment plan with established goals in the case record.
Physical Therapy initial plan limit — 50 hours (200 units)
Initial plan maximumPhysical Therapy limited to no more than 50 hours (200 units) for the initial plan.
DocumentationRequires physician prescription, initial assessment, and treatment plan with goals; service log and signed treatment notes required.
Billing unitServices must be listed on the care plan and billed in 15-minute units.
Positive Behavior Support annual unit limits — 1200 total units; 800 professional units
Annual combined capMaximum 1,200 total units of Positive Behavior Support Services per year (professional + technician combined).
Professional unit capMaximum 800 professional-level units per year.
Service characteristicsUnits measured in 15-minute increments; three provider levels with distinct qualifications and supervision requirements.
Environmental Accessibility Adaptations cap — $5,000 per waiver year
Annual capTotal costs of Environmental Accessibility Adaptations shall not exceed $5,000 per waiver year, per waiver recipient.
ScopePhysical home adaptations necessary for health, safety, or independence (e.g., ramps, grab-bars, widened doorways); must meet building codes.
ExclusionsExcludes general utility or non-medical improvements (e.g., carpeting, roof repair, central AC, added square footage).
Specialized Medical Supplies cap — $2,400 per waiver recipient per year
Annual capSpecialized Medical Supplies are limited to a maximum of $2,400 per waiver recipient per year.
AuthorizationSupplies provided only when authorized by the waiver recipient's physician and must meet applicable standards of manufacture and design.
RecordkeepingOperating agency must maintain documentation of items purchased for the waiver recipient.
Assistive Technology cap — $5,000 per waiver recipient per year
Annual capAssistive Technology Services are capped at $5,000 per waiver recipient per year.
OrdersVerbal or written orders from a physician or licensed provider required for nonprescription assistive technology items authorized in the person-centered plan.
PurposeItems/services to increase or maintain functional capabilities; must meet documentation and authorization requirements.
Respite care maximum — 1080 hours / 45 days per waiver year
Maximum hours/daysRespite Care Services limited to a maximum of 1,080 hours or 45 days per waiver recipient per waiver year.
DeliveryProvided in- or out-of-home; can be self-directed with employer-of-record responsibilities when applicable.
Relative as workerA relative may serve as a self-directed respite worker if not the legally responsible individual or guardian and other conditions are met.
Community Specialist duration limit — typically 30–60 days; limited to 90 days per waiver year
Typical durationCommunity Specialist Services are time-limited and typically last 30–60 days.
Annual limitServices are limited to no more than 90 days per waiver year when needed.
PurposeTask-specific services including assessment, program design, training, consultation, and advocacy to implement the Person-Centered Plan.
Goods and Services annual purchase cap — $10,000
Annual purchase capLimit on Goods and Services purchases determined individually but not to exceed $10,000 annually.
Determination basisAmount based on the balance of the waiver recipient's savings account maintained by the Financial Management Services Agency at time of request.
Use criteriaGoods and Services must be cost-effective and directly beneficial to the waiver recipient per the person-centered plan.
Community Specialist duration limit — Community Experience group maximum size — 4 recipients
Maximum group sizeCommunity Experience Group Services may include up to four (4) waiver recipients per staff configuration.
Individual ratioCommunity Experience Individual Services are provided one-to-one when determined necessary through assessments.
PurposeNon-work activities outside the residence to acquire or use adaptive skills and engage in community participation.
Annual per-client waiver cap — $58,000 (crisis intervention excluded)
Annual per-client capWaiver cost per client will not exceed $58,000 per client per year; crisis intervention services are excluded from the cap.
Program constraintThe waiver program must not exceed on an average per capita basis the expenditures that would be incurred if HCBS were not available.
Effective datesPolicy amended and effective August 14, 2025 (amendment history noted).
Provider Enrollment, Billing, and Operational Requirements
Documentation Required
Signed contract, qualifications, and legal compliance
Each provider must have a signed provider contract, meet applicable provider qualifications, and comply with all applicable state and federal laws and regulations; services reimbursable through EPSDT cannot also be reimbursed under the LAH waiver.
- Signed provider agreement required
- Must meet state licensure/certification and provider qualifications
- Must comply with state and federal laws and regulations
- EPSDT-reimbursable services are excluded from LAH waiver reimbursement
Billing Rule
Transportation included in habilitation service rates
Transportation that occurs between habilitation service sites or as part of Prevocational/Day Habilitation is considered a component of the habilitation service and is included in the service rate; Day Habilitation has a separate transportation rate structure and Day Habilitation itself is limited to five hours per day.
- Transportation between residence and provider facility or between Prevocational sites is a component of the service
- Day/Community Habilitation has four reimbursement levels and four transportation levels tied to staffing ratios
- Day Habilitation cannot exceed five hours per day
Prior Authorization
Physical Therapy: orders, documentation, and 15‑minute billing
Physical Therapy requires a physician's prescription, an initial assessment, and a documented treatment plan with established goals in the case record; providers must maintain service logs and signed treatment notes and bill PT in 15‑minute units with the initial plan limited to 50 hours (200 units).
- Physician prescription required
- Initial assessment and treatment plan with goals must be in case record
- Physical therapist must document and sign each treatment note (e-signatures allowed if secure)
- Maintain service log documenting specific days PT delivered
- Bill in 15‑minute units; initial plan limited to 50 hours (200 units)
Prior Authorization
Positive Behavior Support: documentation, supervision, and annual unit limits
Positive Behavior Support Services require documentation including functional behavior analysis and a behavior support plan; providers must maintain service logs, adhere to provider-level qualifications and supervision requirements, and observe annual unit maximums (1200 combined units per year, maximum 800 professional units). Group therapy is not reimbursable and behavior management plans must be reviewed every 30 days.
- Functional behavior analysis and BSP required
- Service log documenting specific days of delivery
- Provider-level distinctions and supervision required
- Behavior management plans reviewed/re-justified every 30 days
- Maximum 1200 combined units/year and max 800 professional units/year
- Group therapy will not be reimbursed
Prior Authorization
Skilled Nursing: plan inclusion, licensing, hourly billing, and self-direction
Skilled Nursing must be included in the approved person-centered care plan, provided by appropriately licensed nurses within the Nurse Practice Act scope, billed by the hour, and may be self-directed when the participant is self-directing Personal Care Services; nursing may include training and supervision related to medical care and assistance with ordinarily self-administered medications by the personal care worker.
- Skilled Nursing listed on approved person-centered care plan
- Provided by RN or LPN/LVN under RN supervision and licensed in state
- Billed by the hour
- May be self-directed when Personal Care is self-directed
- Includes training/supervision related to medical care and assistance with medications
Billing Rule
Claims deadlines and unit‑based payment methodology
Submit all claims within one year from the date of service; payment is based on the rate in effect on the date of service and on the number of units reported for each HCPC code.
- All claims must be submitted within one year of date of service
- Payment based on rate in effect on date of service
- Payment determined by number of units reported for each HCPC code
- Waiver year costs and units must be captured on CMS 372 report
Documentation Required
Medicaid enrollment, licensure, and sanctions for misrepresentation
Providers must enroll with Medicaid's fiscal agent and meet state licensure/certification and Alabama Medicaid Provider Manual requirements; failure to provide accurate truthful information or intentional misrepresentation may result in denial of application or permanent exclusion.
- Enroll with Medicaid's fiscal agent and obtain provider agreement
- Meet licensure/certification requirements of state and federal regulations and Provider Manual
- Accurate and truthful information required; misrepresentation may lead to denial or permanent exclusion
Prior Authorization
LTC Admissions Notification transmission and authorization to begin billing
Upon receipt of the financial award letter, complete and electronically transmit the LTC Admissions Notification Form to Medicaid's Fiscal Agent; if accepted the information writes to the Level of Care file and the provider may begin services and billing; rejected transmissions must be corrected and retransmitted and successful transmission is the record of approval to begin services.
- Complete LTC Admissions Notification Form upon financial award letter
- Transmit electronically to Medicaid's Fiscal Agent and check next business day for acceptance/rejection
- Accepted transmission writes to Level of Care file and authorizes service start and billing
- Rejected transmissions must be corrected and retransmitted
- Successful transmission serves as approval to begin rendering service (no LTC-2 letters sent)
Denial Risk
Recoupment risk when medical necessity or eligibility not met
Alabama Medicaid will initiate recoupment of payments when state or federal medical necessity or eligibility requirements are not met and may seek recoupment from ADMH if eligibility was incorrectly certified by ADMH.
- Medicaid conducts monthly retrospective random-sample reviews for appropriateness of admissions and annual redeterminations
- Recoupment initiated when medical necessity or eligibility requirements are not met
- Medicaid may seek recoupment from ADMH for improperly certified eligibility
Documentation Required
Reiteration: enrollment, licensure, and compliance expectations
Providers of waiver services must enroll with Medicaid's fiscal agent, meet applicable state licensure/certification, and adhere to the Alabama Medicaid Provider Manual; intentional misrepresentation or failure to provide truthful information may result in application denial or exclusion.
- Enrollment through Medicaid's fiscal agent required
- Must meet licensure/certification and Provider Manual requirements
- Misrepresentation may result in denial or permanent exclusion
Key Terms and Service Definitions
LAH Waiver — Living at Home Waiver definition
DefinitionLiving at Home (LAH) Waiver: A Section 1915(c) Medicaid waiver providing Home and Community-Based Services to individuals with intellectual disabilities who would otherwise require ICF/IID level of care.
PopulationRestricted to individuals with a diagnosis of intellectual disability, ages 3 and above, and those not residing in a group home.
AdministrationAdministered cooperatively by the Alabama Medicaid Agency and the Alabama Department of Mental Health.
Provider-owned residential setting (HCBS compliant) — definition and requirements
DefinitionProvider-owned residential setting (HCBS compliant): A unit or dwelling that can be owned, rented, or occupied under a legally enforceable agreement by the individual and provides protections and responsibilities comparable to landlord/tenant law.
Privacy and choiceUnits must have lockable entrance doors, freedom to furnish/decorate, choice of roommates, control of schedule and visitors, and access to food at any time.
ModificationsAny modifications to requirements must be supported by assessed need, justified and documented in the person-centered plan.
Physical Therapy — definition
DefinitionPhysical Therapy Services: Evaluation and treatment to preserve/improve independent function (range of motion, strength, coordination) and prevent progressive disability via therapeutic programs and assistive devices.
Provider rolesTherapists may provide consultation and training to staff or caregivers when directly benefiting the recipient and enabling care outside an institution.
Authorization and documentationRequires physician prescription, initial assessment, treatment plan with goals, service logs, and signed treatment notes.
Positive Behavior Support Services — definition and provider level distinctions
DefinitionPositive Behavior Support Services: Systematic functional behavior analysis, BSP development, consultation, environmental manipulation and training to implement BSP for recipients with maladaptive behaviors jeopardizing habilitation or community integration.
Levels and providersThree provider levels: Level 1 professional, Level 2 professional, Level 3 technical, each with distinct qualifications and supervision requirements.
Documentation and limitsProviders must maintain service logs; group therapy not reimbursed; units billed in 15-minute increments with annual unit limits (1200 combined, 800 professional).
Personal Care Services — definition including ADLs/IADLs and 15-minute billing
DefinitionPersonal Care Services: Assistance with ADLs (bathing, toileting, transfer, grooming, dressing, meal prep, etc.) and IADLs (shopping, banking, budgeting, transportation, social interaction).
Scope and supervisionMay include general supervision and protective oversight; requires a written description in the person-centered care plan and Division approval when applicable.
Billing unitBilled in 15-minute units; generally not approved for recipients in group homes unless non-duplicative purposes are documented.
Environmental Accessibility Adaptations — definition and exclusions
DefinitionEnvironmental Accessibility Adaptations: Physical adaptations to the home required by the approved person-centered care plan to ensure health, welfare, safety, or increase independence.
RequirementsAdaptations must meet applicable State or local building codes and exclude general utility or non-medical improvements.
Self-directionCan be self-directed only by participants who are self-directing personal care and/or nursing services.
Specialized Medical Supplies — definition and annual limits/authorization
DefinitionSpecialized Medical Supplies: Supplies necessary to maintain health, safety, and welfare (including PPE) and to prevent deterioration or increase ADL ability.
Authorization and standardsProvided only when authorized by the physician and must meet applicable manufacturer/ design standards; providers must have signed provider agreements.
Annual limitLimited to a maximum of $2,400 per waiver recipient per year; operating agency must document purchases.
Assistive Technology — definition and caps/authorization
DefinitionAssistive Technology Services: Items or services to increase or maintain functional capabilities of waiver recipients.
Orders and documentationVerbal or written orders from a physician or licensed provider required for nonprescription items authorized in the person-centered plan.
Annual capCapped at $5,000 per waiver recipient per year and subject to authorization and documentation requirements.
Housing/Community Integration Services — assistance definitions
DefinitionHousing/Community Integration Services: Services that enable waiver recipients to maintain housing and community integration per the person-centered plan (assessment, securing housing, documentation, planning, landlord communication, and crisis supports).
DeliveryMust be provided in the home or a community setting and include individualized planning and supports to retain or locate housing when at risk.
ComponentsIncludes assistance securing documents, deposits, furnishings, and participation in Person-Centered Plan meetings.
CWIC — Certified Work Incentives Counselor definition
DefinitionCertified Work Incentives Counselor (CWIC): A benefits counselor certified through recognized SSA training to provide intensive individualized benefits counseling and work incentive planning.
RoleProvides benefits analysis, develops work incentive plans, and assists with ongoing benefits planning for employment transitions or advancement.
Security noteMay require level 5 SSA/DHS security clearance due to handling of personally identifiable information.
Community Experience — definition
DefinitionCommunity Experience Services: Non-work-related, community-based activities customized to the recipient to acquire or use adaptive skills and engage in community participation.
FormatsOffered as Individual (1:1) or Group (staff-to-recipient ratio up to 1:4) determined by assessments and behavioral justification when needed.
TimingProvided outside the residence during day, evening, or weekends.
Remote Support — definition
DefinitionRemote Support Services: Real-time, live two-way electronic monitoring/support provided by awake remote staff to recipients age 18+ at their place of residence.
PurposePromotes autonomy, minimizes dependence on paid in-person staff, and reduces need for more intrusive services.
Technical requirementMust use an appropriate, stable, and reliable electronic connection; not via recordings.
PERS — Personal Emergency Response System definition
DefinitionPersonal Emergency Response System (PERS): A direct telephonic or electronic communications link between recipients and health professionals to secure immediate assistance in emergencies.
ComponentsMay include installation, monthly fees, upkeep, maintenance, and cellular options when conventional PERS is not feasible.
SafeguardsUse requires privacy safeguards, informed consent, and documentation in the person-centered plan.
operating agency — OA definition
DefinitionOperating agency (OA): The entity responsible for reviewing eligibility, adhering to federal/state guidelines, and coordinating assessments, admissions, and redeterminations for LAH Waiver applicants.
ResponsibilitiesReviews medical eligibility, ensures screening/assessment, routes financial applications to Medicaid District Office, and maintains compliance with policies and procedures.
InteractionsCooperates with Alabama Medicaid Agency and ADMH; must provide records for audits and utilization review upon request.
Waiver Coordinator / case manager roles — role definitions and responsibilities
Waiver Coordinator roleCompletes the level-of-care determination for applicants under the LAH Waiver.
Case manager roleDevelops the approved person-centered plan of care, assists with financial application routing to Medicaid District Office, and ensures required documentation is completed.
Additional responsibilitiesOperating agency and case manager ensure screening/assessment, adherence to federal/state guidelines, and maintain records for audits and quality assurance.
Policy Summary
PayerAlabama Medicaid
PolicyHome and Community‑Based Living at Home (LAH) Waiver — Application Process and Coverage Criteria
Policy CodePolicy 560-X-52-.16
Change TypeTechnical / non‑material update
Effective DateAug 14, 2025
Last ReviewJun 30, 2025
Next Review DateN/A
Key ActionComplete and transmit the LTC Admissions Notification Form electronically upon receipt of the financial award letter to authorize service start and billing.
SourceLink
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