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(a) Repealed 5/5/84.
(b) Repealed 5/5/84.
(c) The PRO certification of necessity must appear on the invoice submitted by the hospital in order to receive payment. Payment will be made only for days certified as medically necessary and within the scope of Medicaid coverage. If a recipient refuses to leave the hospital at the end of the certified period of stay, the hospital may bill the patient for days used beyond the certified length of stay. Payment by the division will be payment in full for covered services.
(d) Additional payment from recipient, relatives, recipient's estate, or another source, for services that have been billed to the division must be reported to the division and entered as a credit against the charge.
(e) Invoices submitted for cases continuing from one month into the following month must include a valid medical coupon for each month that the recipient is in the facility.
History: Eff. 8/18/79, Register 71; am 5/5/84, Register 90; am 6/28/85, Register 94; readopt 8/7/96, Register 139
Authority: AS 47.05.010
Editor's note: Effective 8/7/96, Register 139, the Department of Health and Social Services readopted 7 AAC 43.400 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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Last modified 7/05/2006