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In 7 AAC 43.950 - 7 AAC 43.975
(1) "affiliates" means persons having an overt or covert relationship by which any one of them directly or indirectly controls or has the power to control another;
(2) "closed-end provider agreement" means an agreement that is for a specific period of time not to exceed 12 months and that must be renewed in order for the provider to continue to participate in the medicaid program;
(3) "fiscal agent" means an organization which processes and pays provider claims on behalf of the division;
(4) "open-end provider agreement" means an agreement that has no specific termination date and continues in force until terminated in writing by either party;
(5) "person" means any natural person, company, firm, association, corporation including a municipal corporation, or other legal entity;
(6) "provider" means an individual, firm, corporation, association or institution which is providing, or has been approved to provide medical assistance to a recipient under the medicaid program;
(7) "suspension from participation" means an exclusion from participation for a specified period of time;
(8) "suspension of payments" means the withholding of all payments due a provider until the resolution of the matter in dispute between the provider and the division;
(9) "termination from participation" means a permanent exclusion from participation in the Medicaid program;
(10) "withholding of payments" means a reduction or adjustment of the amounts paid to a provider on pending and subsequently submitted bills for purposes of offsetting overpayments previously made to the provider;
(11) "Professional Activity Study" (PAS) means the most recent edition of that study for western states conducted by the Commission on Professional and Hospital Activities.
History: Eff. 8/18/79, Register 71; am 6/28/85, Register 94; readopt 8/7/96, Register 139
Authority: AS 47.05.010
Editor's note: The most recent PAS Study for western states, referred to in 7 AAC 43.985(11) , can be obtained by writing to the Commission on Professional and Hospital Activities, 1968 Green Road, Ann Arbor, Michigan 48105.
Effective 8/7/96, Register 139, the Department of Health and Social Services readopted 7 AAC 43.985 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