(a) Subject to all
other requirements of 7 AAC 105 - 7 AAC 160, the following types of providers
are eligible to enroll with the department and bill directly for services
rendered:
(1) a person with an active license
under AS 08, or under the laws of the jurisdiction in which the person provides
services, to practice as
(A) a physician,
including an osteopath;
(F) a pharmacist or
retail pharmacy;
(G) a physical
therapist;
(H) an occupational
therapist;
(J) a speech-language
pathologist;
(K) an advanced
practice registered nurse;
(L) a
direct-entry midwife;
(P) a hearing aid
dealer;
(Q) a registered nurse
anesthetist; or
(S) a clinical social
worker;
(T) a marital and family
therapist;
(U) a licensed
professional counselor;
(V) a
licensed dental hygienist who holds an advanced practice permit issued by the
Board of Dental Examiners under
AS
08.32.125;
(2) a facility licensed under AS 47.32, or
under the laws of the jurisdiction in which it provides services, to operate as
(A) a general acute care hospital or
inpatient psychiatric hospital;
(B)
a long-term care facility;
(C) a
home health agency;
(D) a rural
health clinic;
(E) an ambulatory
surgical center;
(F) a hospice care
agency;
(G) a residential
psychiatric treatment center for persons under 22 years of age; or
(H) an intermediate care facility for the
mentally retarded (ICF/MR);
(I) a
free-standing birth center;
(3) a company or individual not excluded in
(b) of this section, supplying
(A) medical
transportation, ambulance services, oxygen, or eyeglasses;
(B) under
7
AAC 120.200 -
7
AAC 120.399, durable medical equipment, medical
supplies, prosthetics, orthotics, noncustomized-fabricated orthotics,
respiratory therapy, enteral and oral nutritional products, or home infusion
therapy; or
(C) items paid under
7
AAC 130.305 as specialized medical equipment and
supplies;
(4) a provider
of EPSDT screening services under
7
AAC 110.205;
(5) a facility providing services for
end-stage renal disease;
(6) a
personal care agency;
(7) a home
and community-based waiver services provider, including a provider of
environmental modification services under
7
AAC 130.300;
(8) a care coordination agency provider, as
defined in 7 AAC 130.319;
(9) a residential supported-living services
provider, as defined in
7
AAC 130.319;
(10) a federally qualified health center
(FQHC);
(11) a tribal health
program;
(12) a provider of
in-state freestanding or portable x-ray services;
(13) a provider of behavioral health
rehabilitation services under
7
AAC 135.010(c) for a child
experiencing a severe emotional disturbance as described in
7
AAC 135.065;
(14) a private-duty nursing agency;
(15) a school district providing a
Medicaid-covered service to a Medicaid recipient;
(16) an independent laboratory;
(17) an outpatient therapy center;
(18) a provider of family planning
services;
(19) a provider of
targeted case management services;
(20) a community behavioral health services
provider;
(21) a mental health
physician clinic;
(b) Each of
the following providers must enroll with the department as a rendering
provider, but payment for those services will be made through the rendering
provider's supervising health care provider enrolled under this section:
(1) a licensed physician assistant;
(2) a licensed physical therapy
assistant;
(3) a licensed
occupational therapy assistant;
(4)
a registered speech-language pathologist assistant;
(5) a registered respiratory
therapist;
(6) a certified
respiratory therapy technician;
(7)
a personal care assistant;
(9) a licensed
practical nurse who provides direct services to a recipient as an employee of a
private-duty nursing agency;
(10) a
licensed registered nurse who provides direct services to a recipient as an
employee of a private-duty nursing agency;
(11) a licensed assistant behavior analyst
under 7 AAC 135.300;
(12) an autism behavior technician under
7
AAC 135.300.
(c) Notwithstanding any other provision of 7
AAC 105 - 7 AAC 160, and if the employee has an active license from a
jurisdiction in the United States, a health care provider who is an employee of
the federal government assigned to a tribal health program is exempt from any
requirement in 7 AAC 105 - 7 AAC 160 that the provider be licensed, certified,
or registered by this state to be eligible under this section.
(d) Notwithstanding any other provision of 7
AAC 105 - 7 AAC 160, a hospital, clinic, or other type of health care facility
that is operated by a tribal health program is exempt from a requirement in 7
AAC 105 - 7 AAC 160 that the provider be licensed or certified by this state to
be eligible under this section.
(e)
If a rendering provider identified in (b) of this section is an employee of or
under contract with an enrolled tribal health program, that tribal health
program is the supervising health care provider of that rendering provider for
the purposes of receiving payment under 7 AAC 105 - 7 AAC 160.
