State of Alabama and PrimeHealth (Mobile, AL)

Pacific Health Policy Group (PHPG) activities included:

• Conducting of budget neutrality analysis and drafting of the caseload/cost estimate chapter of the state's Section 1115 Demonstration Waiver proposal for submission to the Centers for Medicare & Medicaid Services (CMS)

• Assisting in negotiating terms and conditions under which the program will operate with the federal government and in drafting the contract to be executed by the state and PrimeHealth

• Providing extensive assistance to PrimeHealth in reevaluating operational changes that will be necessary for the health plan to enroll and serve Medicaid beneficiaries

• Assisting PrimeHealth in its contracting negotiations with the state, in terms of defining operational responsibilities for the two parties and appropriate capitation rates