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 105.140 - Covered services during declared disaster emergency
Universal Citation: 7 AK Admin Code 105.140
Current through November 28, 2024
(a) Notwithstanding the provisions of 7 AAC 105.610, 7 AAC 110.750, 7 AAC 120.112, 7 AAC 145.400, and 7 AAC 145.410, the department may make adjustments to covered services listed under (b) of this section for the length of a declared disaster emergency if
(1) the governor issues
a disaster emergency declaration for the state or a region within the state
under AS
26.23.020;
(2) the federal government issues a related
disaster declaration or declaration of national emergency for the state or a
region within the state under
42 U.S.C.
5121-
5207 (Stafford
Disaster Relief and Emergency Assistance Act) or
50 U.S.C.
1601-
1651
(National Emergencies Act) and the Secretary of the United States Department of
Health and Human Services invokes authority under
42
U.S.C. 1320b-5(b) (sec.
1135(b) of the Social Security Act), with respect to the secretary's
declaration of a public health emergency as described under
42
U.S.C. 1320b-5(b) and
(g)(1), to waive or modify certain
requirements of titles XVIII, XIX, and XXI of the Social Security Act as a
result of the disaster declaration; and
(3) the state either
(A) applies for and receives an approved
disaster relief state plan amendment, authorized under
42
U.S.C. 1320b-5, based on the disaster
emergency declaration, to make the changes provided for in this section;
or
(B) has existing state plan
authority from CMS to exercise the provisions of (b) of this section during a
declared disaster emergency.
(b) If the conditions listed in (a) of this section are met, the department may
(1) for
covered outpatient drugs under 7 AAC 105 - 7 AAC 160,
(A) extend the fill duration authorization
under 7 AAC 120.112(4)
from a 34-day to 68-day supply;
(B)
increase the professional dispensing fee rates for in-state claims under
7
AAC 145.410(a)(1) and (2) by up to
$2.50;
(C) increase the
professional dispensing fee reimbursement frequency under
7
AAC 145.410(a)(1) and (2) to not more
than once every 14 days;
(D) allow
ingredient reimbursement at actual acquisition cost if the actual acquisition
cost is above the lowest determined cost under the formula provided in
7
AAC 145.400 and the provider maintains proof of the
actual acquisition cost of the drug consistent with
7
AAC 105.230, substantiated by an unaltered invoice
under 7 AAC 105.240;
(E) waive the cost-sharing amounts eligible
recipients are required to pay under
7
AAC 105.610(a)(4), if the service is
related to screening for, diagnosing, or treating the condition at issue in a
public health emergency; or
(F)
waive the requirement under
7
AAC 145.400(j) that a provider return
to the pharmacy covered but unused outpatient drugs dispensed in unit doses to
a recipient in a long-term care facility, if a public health emergency includes
a risk of infection control;
(2) for vaccines authorized by the Federal
Drug Administration in response to a public health emergency, reimburse
providers under
7
AAC 110.750, consistent with
7
AAC 145.020; or
(3) reimburse a registered pharmacist acting
within the scope of the person's practice under 12 AAC 52 for services
consistent with 7 AAC 105-7 AAC 160 and with this subsection during the
disaster emergency, including providing testing and other services authorized
by a standing order of the chief medical officer when not explicitly defined
within the scope of the person's practice.
(c) Reimbursements provided for under this section may be requested or disbursed after a declaration of emergency has expired, within standard timely filing under 7 AAC 145.005, for services provided during the emergency.
Authority:AS 47.05.010
AS 47.07.030
AS 47.07.040
Disclaimer: These regulations may not be the most recent version. Alaska may have more current or accurate information. We make no warranties or guarantees about the accuracy, completeness, or adequacy of the information contained on this site or the information linked to on the state site. Please check official sources.
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