Alaska Administrative Code
Title 7 - Health and Social Services
Part 8 - Medicaid Coverage and Payment
Chapter 105 - Medicaid Provider and Recipient Participation
Article 1 - Medicaid Program; Scope and Authorization of Service
7 AAC 105.110 - Noncovered services

(1) not reasonably necessary for the diagnosis and treatment of an illness or injury, or for the correction of an organic system, as determined upon review by the department or that is not identified in a screening required under 7 AAC 110.205;

(2) not properly prescribed or medically necessary in accordance with criteria established under 7 AAC 105 - 7 AAC 160 or by standards of practice applicable to the prescribing provider;

(3) incurred for an evaluative or periodic checkup, examination, or immunization

(4) for or in connection with cosmetic therapy or plastic or cosmetic surgery, including rhinoplasty, nasal reconstruction, excision of keloids, augmentation mammoplasty, silicone or silastic implants, facioplasty, osteoplasty (prognathism and micronathism), dermabrasion, skin grafts, and lipectomy; however, coverage is available if required for the following corrective actions if performed within the normal course of treatment or otherwise beginning no later than one year after birth or the event that caused the need for the corrective action:

(5) a nonmedical charge imposed by a recipient's friend or relative;

(6) for a person who is in the custody of the federal, state, or local law enforcement, including a juvenile in a detention or correctional facility, except as an inpatient in a medical institution;

(7) for an experimental or investigational service, except for covered routine patient costs associated with clinical trials specified in 42 U.S.C. 1396d(gg)(1), adopted by reference in 7 AAC 160.900; for the purposes of this paragraph, an experimental or investigational service for which the department will not pay includes one

(8) for missed appointments; however, the provider may charge the recipient;

(9) for interpreter services;

(10) for infertility services;

(11) for impotence therapy and services;

(12) Repealed 7/25/2021.

(13) for sterilization for recipients under 21 years of age and hysterectomies performed solely for sterilization purposes;

(14) for nonsurgical weight reduction or maintenance treatment programs and products;

(15) for nonmedical fitness maintenance centers and services;

(16) for educational services or supplies that are separately identifiable in the United States Department of Health and Human Services, Centers for Medicare and Medicaid Services' (CMS) Healthcare Common Procedure Coding System (HCPCS), adopted by reference in 7 AAC 160.900;

(17) an alternative therapy or other service including acupuncture, homeopathic or naturopathic remedy, or Ayurvedic medicine;

(18) an outpatient drug for which payment under the United States Department of Health and Human Services, Centers for Medicare and Medicaid Services' drug rebate program established in 42 U.S.C. 1396r-8 is not available;

(19) for which the recipient does not meet the eligibility requirements for that service under 7 AAC 100; or

(20) after the recipient's date of death.