7 AAC 43.170. Conditions for payment

(a) Requirements for payment under medicaid as an SNF or ICF are that

(1) the facility has been certified by the division as being in compliance with federal certification requirements, as follows:

(A) SNF certified for medicaid - certification is by the division for the United States Department of Health and Human Services;

(B) ICF - certification is by the division;

(2) a level-of-care decision has been made by the division or the division's designee, subject to the division's approval, indicating that the recipient requires the level of care that the facility is certified to provide;

(3) there is a current provider agreement on file with the division.

(b) Payment will be made by the division in accordance with 7 AAC 43.670 - 7 AAC 43.709.

History: Eff. 8/18/79, Register 71; am 5/5/84, Register 90; am 6/27/84, Register 91; readopt 8/7/96, Register 139; am 11/13/97, Register 144

Authority: AS 47.05.010

AS 47.07.070

Editor's note: Effective 8/7/96, Register 139, the Department of Health and Social Services readopted 7 AAC 43.170 in its entirety, without change, under AS 47.05 and AS 47.07. Executive Order No. 72 transferred certain rate-setting authority to the department.

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