Alaska Administrative Code
Title 7 - Health and Social Services
Part 8 - Medicaid Coverage and Payment
Chapter 145 - Medicaid Payment Rates
Article 11 - Payment Rates; Rural Health Clinic and Federally Qualified Health Center Services
7 AAC 145.770 - SEMT interim supplemental payment

Universal Citation: 7 AK Admin Code 145.770

Current through November 28, 2024

(a) For SEMT, the department will pay an interim supplemental payment that approximates the SEMT costs eligible for federal financial participation claimed through the certified public expenditure (CPE) process.

(b) The department will calculate the interim supplemental payment rate for SEMT on an annual basis per cost report. The department will pay one interim payment not later than the end of the second quarter following the cost report submission.

(c) The department will determine the interim supplemental payments using the most recently filed cost reports provided under 7 AAC 145.760. The cost reports will be used to determine an average cost per qualifying medical transport, using the following calculation:

(1) the sum of a participating provider's allowable direct and indirect costs for ground, air, and water medical transport services will be divided by the number of medical transports, separated into ground, air, and water services by the service-specific components, to determine a participating provider's average cost per medical transport for each ground, air, or water service;

(2) the average cost per medical transport for each ground, air, or water service will be multiplied by the number of qualifying Medicaid fee-for-service emergency medical transports to determine allowable Medicaid emergency medical transportation costs;

(3) the allowable Medicaid emergency medical transportation costs will be offset by Medicaid revenue for fee-for-service (FFS) and third party liability (TPL) for Medicaid emergency medical transports, to calculate the Medicaid emergency medical transportation costs that have not been paid by any other source;

(4) the calculated Medicaid emergency medical transportation costs not paid by any other source will be multiplied by the federal medical assistance percentage (FMAP), within the meaning given in 42 U.S.C. 1396d(b) (sec. 1905(b), Title XIX, Social Security Act), to determine the interim payment.

(d) The cost per medical transport per participating provider utilizes provider-specific data and varies from provider to provider. The department will calculate the amount of interim supplemental payments among the participating providers, in varying amounts based on the provider-specific data.

Authority:AS 47.05.010

AS 47.07.040

AS 47.07.085

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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