None of the Alabama documents we hold creates a state license for non-medical home care. Home health agencies need a Certificate of Need, Medicare certification and health department certification. Hospices are the in-home providers the health department clearly licenses.
Red means act now, amber means read it this month, grey is for the record.
At CMS's request, Medicaid is revalidating providers off-cycle. Home health agencies and hospices are high-risk and will revalidate immediately. Private duty nursing is moderate or limited risk and will revalidate over 24 months. Notices go out in phases.
Chapters 35 (ID waiver) and 52 (Living at Home waiver) were amended effective July 13. Chapter 11 rule 560-X-11-.14 (EPSDT services, including private duty nursing) was amended effective Aug. 14.
The state posted a draft renewal of the ACT waiver with a 30-day public comment notice.
Dates taken from the rules and notices as we read them.
Due by the 5th of every month, 5:00 PM Central, with visit data for claims billed the month before.
Every state follows the same outline, so you always know where to look. Open a section for the detail.
Sometimes two official documents say different things. Here is what we went with, why, and what each document says, so you can judge for yourself.
The Medicaid home health rule asks for health department certification, not a license, and the health department's license forms don't list home health. But two 2026 draft waiver applications say a home health agency "must be licensed." The drafts are not final. Until the health department's own home health rules settle it, ask the Division of Health Care Facilities which applies to you.
Every answer was written and checked ahead of time, with the official document next to it. Nothing is made up on the spot.
Not a state license, based on the documents we hold.
The health department's license application forms list hospices, hospitals, nursing homes, assisted living and other facilities, but no category for non-medical home care, companion or personal care agencies. If you bill Medicaid, the controls are Medicaid enrollment and the waiver rules. The 2026 ACT waiver draft asks home care agencies for local (county or city) business or privilege licenses, licensed nurse supervisors and a "Waiver of Certificate of Need" approved by Alabama Medicaid.
You need a Certificate of Need plus Medicare and health department certification.
To enroll with Medicaid, a home health agency must be certified as a Medicare provider and certified by the Alabama Department of Public Health as meeting the Conditions of Participation (rule 560-X-12-.03). The 2026 waiver drafts add that a home health agency must hold a Certificate of Need under Ala. Code § 22-21-260 et seq. Only in-state agencies can enroll with Medicaid.
It depends on the service.
Home health and private duty nursing providers must get their own EVV system and complete the EVV Attestation Form before enrolling. Medicaid denies the application without it. The form also covers the TA waiver. Providers (or their EVV vendors) send the visit data to Medicaid, which acts as the aggregator, in a monthly file due by the 5th. Waiver in-home services are verified through the state-contracted EVV system.
Every quarter.
Medicaid publishes each edition as a "Quarterly Revision" that replaces the whole manual. The April and July 2026 editions are the latest we hold. Each has a Summary of Changes listing the pages that changed, and changes are marked in the margins.
Seven.
Elderly & Disabled, SAIL, ACT, Technology Assisted for Adults, Intellectual Disabilities, Living at Home, and the Community Waiver Program.
No.
Alabama's Integrated Care Network (ICN) is a care-coordination program, not a health plan. It is paid a monthly amount for case management for Elderly & Disabled and ACT waiver participants. Waiver service providers bill Medicaid directly.
Call your county DHR office, or the police or sheriff, right away.
Under the Adult Protective Services Act (Ala. Code 38-9-8), caregivers must report by phone or in person immediately, then follow up in writing. Reports go to the county Department of Human Resources, the city police chief, or the sheriff. DHR also takes online reports through dhr.alabama.gov and publishes a reporting form. A separate financial exploitation form is for financial professionals.
Three Medicaid rule chapters were amended.
Chapter 35 (ID waiver) and chapter 52 (Living at Home waiver) were amended effective July 13, 2026. In chapter 11 (EPSDT), rule 560-X-11-.14, which includes private duty nursing, was amended effective August 14, 2026. Medicaid posted the updated chapters on August 26. The ACT waiver renewal draft went out for comment on August 21, and comments closed on September 21.
The official link for each document. Our own dated copies will sit next to them, so a document is still here when a state moves its website.
64 documents — showing the newest 25