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(a) The division will enroll as a Medicaid provider of hospice care services a public or private organization that the division has certified as a hospice for purposes of the Medicare program under 42 C.F.R. Part 418, revised as of October 1, 1994, and that provides hospice care services for periods of at least 210 days.
(b) The division will reimburse an in-state enrolled hospice at the Medicaid rates established annually by the health care financing administration, United States Department of Health and Human Services, for routine home care, continuous home care, inpatient respite care, and general inpatient care. The hospice must reimburse a participating facility for general inpatient and inpatient respite care.
(c) In addition to the rates described in (b) of this section, the division will reimburse an in-state enrolled hospice for the cost of room and board for care provided to a recipient in a nursing home or intermediate care facility for the mentally retarded if the hospice has a written agreement under which the hospice takes full responsibility for the professional management of the recipient's hospice care and the nursing home or facility agrees to provide room and board to the recipient. The room and board payment rate is 95 percent of the daily rate established under 7 AAC 43.670 - 7 AAC 43.709.
(d) The division will not reimburse a hospice for inpatient days, including respite care, that exceed 20 percent of the aggregate number of days of hospice care provided to all recipients during each year beginning November 1 and ending October 31 of the previous year. The hospice must refund to the division the excess payments less the routine home care rate for each day over the 20 percent of the total hospice days billed.
History: Eff. 8/13/95, Register 135
Authority: AS 47.05.010
Editor's note: A copy of the rate schedule described in 7 AAC 43.939(b) may be obtained by contacting the Department of Health and Social Services, division of medical assistance, P.O. Box 110660, Juneau, Alaska 99811-0660.
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Last modified 7/05/2006