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(a) The parents of a child in department custody are expected to be responsible for necessary medical, dental, diagnostic, and therapeutic services for the child.
(b) If the child is eligible to receive medicaid benefits, payment for the medical, dental, diagnostic, and therapeutic care of a child placed in an out-of-home care setting by the division will be made through the medicaid program. Medicaid coupons must be furnished to the medical provider by the out-of-home care provider to enable the medical provider to bill the division for services rendered.
(c) The division is financially responsible for routine medical, dental, diagnostic, and therapeutic services for a child placed in an out-of-home care setting who is not eligible under the medicaid program and who has no other resources, such as Champus, the Alaska Native Health Service, or the child's parents, to meet these needs. The medical provider may bill the division directly for these services. Prior authorization from the division is required.
(d) An out-of-home care provider is expected to obtain routine medical and dental care for a child in accordance with 7 AAC 50.455. The out-of-home care provider must receive prior authorization from the division before discretionary medical or dental treatment, such as orthodontal work, is done. Medicaid covers all basic needs, and discretionary work will not be reimbursed unless pre-authorized as consistent with the child's placement plan. Medicaid criteria will be used by the division to determine if a procedure or treatment is routine, regardless of the child's eligibility for medicaid.
(e) For emergency medical and dental treatment, the out-of-home care provider may seek treatment immediately without prior authorization, but must notify the division as soon as possible.
History: Eff. 11/23/78, Register 68; am 7/1/90, Register 114; am 1/1/96, Register 136
Authority: AS 47.05.010
Editor's note: The substance of 7 AAC 53.320 was formerly contained in 7 AAC 50.820.
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Last modified 7/05/2006