Alaska Administrative Code
Title 7 - Health and Social Services
Part 8 - Medicaid Coverage and Payment
Chapter 140 - Medicaid Coverage; Facility and Facility-Based Services
Article 9 - Facilities Providing Services for End-Stage Renal Disease
7 AAC 140.720 - End-stage renal disease payment conditions
Universal Citation: 7 AK Admin Code 140.720
Current through November 28, 2024
(a) The department will pay an end-stage renal disease facility under 7 AAC 145.607 for the recipient's first day of treatment through the last day of the third month of treatment.
(b) The department will continue to pay a facility for outpatient end-stage renal disease services beginning the fourth month of treatment only if
(1) the recipient
(A) is enrolled in Medicare Part B;
or
(B) has been determined
ineligible for Medicare Part B, and the ineligibility is not related to failure
to comply with any part of the Medicare enrollment process; and
(2) the first claim for services
beginning the fourth month of treatment is accompanied by written verification
of Medicare eligibility or the reason for ineligibility.
(c) If the recipient is not enrolled in Medicare Part B at the commencement of treatment,
(1) the end-stage renal disease facility must
ensure that a Medicare application is made by or on behalf of the recipient;
and
(2) the claim for the
recipient's first treatment for end-stage renal disease must be accompanied by
(A) a photocopy of the recipient's completed
Form CMS-2728-U3, End Stage Renal Disease Medical Evidence Report -
Medicare Entitlement and/or Patient Registration, signed by both the
patient and the attending physician;
(B) verification from the United States
Social Security Administration that an application for Medicare Part B has been
made by or on behalf of the recipient; or
(C) a Medicare Part B enrollment
denial.
(d) The end-stage renal disease facility shall notify the department of each change in the recipient's Medicare status or eligibility.
Authority:AS 47.05.010
AS 47.07.030
AS 47.07.040
AS 47.07.070
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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