7 AAC 43.365. Conditions for payment

To receive payment under Medicaid, a hospital must

(1) be licensed under AS 18.20 and 7 AAC 12, except for a hospital operated by a tribal organization, as defined in 25 U.S.C. 450b(1), under a funding agreement under 25 U.S.C. 458aaa-4 (Indian Self-Determination and Education Assistance Act and Tribal Self-Governance Amendments of 2000);

(2) comply with the requirements of this chapter;

(3) have a division-approved plan of utilization review;

(4) have a current provider agreement on file with the division; and

(5) comply with any prior authorization requirements established under 7 AAC 43.025 for inpatient or outpatient hospitals for surgical procedures, admissions, or continued stay.

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 3/26/2003, Register 165

Authority: AS 47.05.010

AS 47.07.050

Editor's note: Effective 8/7/96, Register 139, the Department of Health and Social Services readopted 7 AAC 43.365 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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