Title 7 . Health and Social Services

Chapter 12 . Assistance for Community Health Facilities

Section 190. Designation of critical access hospital under medicare

7 AAC 12.190. Designation of critical access hospital under medicare

(a) The department will designate a hospital that is licensed under this chapter as a critical access hospital under Medicare if the hospital meets the conditions of participation set out at 42 C.F.R. 485.601 - 42 C.F.R. 485.645, as amended through July 1, 1999 and adopted by reference, and the requirements of this section.

(b) To be eligible for designation as a critical access hospital under Medicare, a hospital must satisfy the criteria set out at 42 U.S.C. 1395i-4(c)(2)(B) and hold a license under 7 AAC 12 as a hospital. An eligible hospital that wishes to be designated as a critical access hospital under Medicare must submit to the department

(1) an application on a form provided by the department;

(2) a description of the area served by the applicant;

(3) a community needs assessment analyzing the availability and utilization of health care services in the applicant's service area, including acute care, primary care, and emergency services, and a discussion of how operating as a critical access hospital under Medicare will better serve community needs;

(4) the applicant's plan for the delivery of health services within the applicant's service area;

(5) a financial feasibility study that analyzes the financial impact on the applicant of operating as a critical access hospital under Medicare, taking into account relevant operational factors, including changes in utilization, services, staffing, and Medicare reimbursement;

(6) a community education plan that describes the steps that have been or will be taken to educate and involve the residents of the service area in the decision to operate as a critical access hospital under Medicare;

(7) an emergency services plan that coordinates the provision of emergency medical services in the applicant's service area;

(8) a description of the volume capacity of the applicant and other related health care resources within the applicant's service area;

(9) the distance and travel time to other health care resources within the applicant's service area; and

(10) identification of barriers to accessing health care in the applicant's service area.

(c) Within 30 days after receipt of an application for designation as a critical access hospital under Medicare, the department will review the application for completeness. If the application is complete, the department will evaluate the application and designate the hospital as a critical access hospital under Medicare if the department determines that the applicant meets the requirements of this section.

(d) If the application submitted under (b) of this section is not complete or an applicant does not meet the requirements of this section, the department will

(1) return the application for additional information, as necessary; or

(2) decline to designate the applicant as a critical access hospital under Medicare.

(e) The department will, in its discretion, certify a hospital as a "necessary provider of health care services" for the purposes of 42 U.S.C. 1395i-4(c)(2)(B)(i)(II) if the hospital is less than a 35-mile drive from another hospital or, in the case of mountainous terrain or in areas with only secondary roads available, is less than a 15-mile drive from another hospital, and if the other hospital provides services only to a certain population group or subgroup and does not routinely provide services to all members of the community in which it is located.

(f) In this section, "critical access hospital under Medicare" means a critical access hospital under 42 U.S.C. 1395i-4 (Medicare Rural Hospital Flexibility Program).

History: Eff. 9/1/2000, Register 155

Authority: AS 18.05.030

AS 18.05.040

AS 18.20.010

AS 18.20.060

AS 47.05.010

AS 47.05.050