7 AAC 72.540. Decision regarding eligibility for financial assistance

(a) The department will review information submitted under 7 AAC 72.530 to verify that the patient meets the eligibility requirements of AS 47.31.010 and that each service for which financial assistance is sought is an eligible service under 7 AAC 72.520(a) or (b). Subject to the disclosure restrictions of 42 C.F.R. Part 2 for a patient who has also received treatment for alcohol or drug abuse in a facility that receives federal financial assistance as described in 42 C.F.R. Part 2, the department may, after 10 days notice to the facility, review all financial and medical records related to a patient for whom application for financial assistance has been made.

(b) If the department determines that the patient is eligible for financial assistance, payment will be made directly to the designated facility that provided any service listed in 7 AAC 72.520(a) or (b), as required by AS 47.31.030 .

(c) If the department determines that the patient is ineligible for financial assistance, or that a service provided is not eligible under 7 AAC 72.520, the department will, as required by AS 47.31.020 , notify the patient and the designated facility that the application for financial assistance has been denied, and will advise the patient, the patient's legal representative, if any, and the designated facility of the right to appeal the denial of assistance under AS 47.31.035 .

History: Eff. 3/16/2001, Register 157; am 6/24/2004, Register 170

Authority: AS 47.30.660

AS 47.31.025

AS 47.31.090

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