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 145.799 - Definitions

Universal Citation: 7 AK Admin Code 145.799

Current through November 28, 2024

(1) "allowable cost" means an expenditure that meets the test of the appropriate Executive Office of the President of the United States' Office of Management and Budget (0MB) circular;

(2) "cognizant agency" means the federal agency with the largest dollar value of a direct federal award with a governmental unit or component;

(3) "department" means the Department of Health and Social Services;

(4) "desk review" means an analysis of cost report data submitted by a provider to determine whether costs are reasonable and allowable for reimbursement under federal and state regulations;

(5) "direct costs" means costs included under 45 C.F.R. 75.413 that may be

(A) identified specifically with a particular final cost objective, such as a federal award or other internally or externally funded activity, to meet emergency medical transportation requirements; or

(B) directly assigned, with a high degree of accuracy, to an activity described in (A) of this paragraph;

(6) "direct federal award" means an award that the federal government pays directly;

(7) "dry run" means SEMT services provided by an eligible SEMT provider to an individual who is released on the scene without transportation by ground, air, or water ambulance to a medical facility;

(8) "emergency medical transport" means any ground, water, or air ambulance transport that

(A) was initiated through the 911 system; and

(B) is determined to be all Medicaid claims in a paid status under the provider types for ground ambulance, inclusive of water ambulance, and for air ambulance, except those claims for Medicare recipients with dual eligibility for Medicaid and except for dry runs;

(9) "federal financial participation" or "FFP" means the portion of medical assistance expenditures for emergency medical services paid or reimbursed by the Centers for Medicare and Medicaid Services (CMS) in accordance with the state plan prepared under AS 47.07.040 for medical assistance;

(10) "indirect costs" means costs that

(A) cannot be readily assigned;

(B) are for a common or joint purpose benefitting more than one cost objective; and

(C) are allocated to each cost objective using a department-approved indirect rate or an allocation methodology;

(11) "publicly owned or operated" means owned or operated by

(A) a state;

(B) a city, county, home rule municipality, borough, special purpose district, or other governmental unit in that state that has taxing authority or direct access to tax revenues; or

(C) an Indian tribe or tribal organization within the meanings given in 25 U.S.C. 5304(e) and (Z) (secs. 4(e) and (/) of the Indian Self Determination and Education Assistance Act);

(12) "SEMT services" means the transport of an individual from any point of origin to the nearest medical facility capable of meeting the emergency medical needs of the individual, including advanced, limited-advanced, and basic life support services provided to an individual by SEMT providers before or during transportation;

(13) "service period" means the provider's fiscal year.

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.
This site is protected by reCAPTCHA and the Google Privacy Policy and Terms of Service apply.