Title 7 . Health and Social Services

Chapter 43 . Hearings

Section 405. Admission

7 AAC 43.405. Admission

(a) Admission of a recipient for inpatient hospital services must be by a physician's order.

(b) If admission is for nonemergency inpatient hospital services, payment is made only if the services have been authorized as appropriate by the division before admission to the hospital. Failure to obtain authorization will result in non-payment regardless of the eligibility of the recipient or the appropriateness of the services.

(c) If admission is for emergency inpatient hospital services, the hospital must notify the division within three working days after admission. If a recipient is eligible for coverage under 7 AAC 43.020, payment is made for emergency hospital services only if the services have been determined to be appropriate by the division; failure to notify the division will result in non-payment regardless of the eligibility of the recipient or the appropriateness of the services.

(d) Payment is made only for those recipients who are eligible for medicaid coverage at the time they receive hospital care. The hospital is encouraged to contact the division if questions exist as to a person's eligibility for medicaid coverage.

History: Eff. 8/18/79, Register 71; am 3/25/83, Register 85; readopt 8/7/96, Register 139

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 43.405 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.