Alaska Administrative Code
Title 7 - Health and Social Services
Part 8 - Medicaid Coverage and Payment
Chapter 145 - Medicaid Payment Rates
Article 9 - Payment Rates; Facility and Facility-Based Services
7 AAC 145.650 - ICF and SNF all-inclusive rates
Universal Citation: 7 AK Admin Code 145.650
Current through November 28, 2024
(a) The rate established for an intermediate care facility or a skilled nursing facility includes all services, supplies, and equipment required for complete care, except as otherwise provided in this section.
(b) The following services are included in the ICF or SNF all-inclusive rate and will not be paid for separately:
(1) rehabilitative nursing care, including
service of restorative aides and nurses, as part of nursing and supportive care
services;
(2) nonprescription
drugs;
(3) direct physical or
occupational therapy services to an individual recipient, prescribed by a
physician;
(4) consultation,
training, and other nondirect recipient care services by a physical therapist,
physical therapy assistant, occupational therapist, or occupational therapy
assistant, whether or not the therapist or assistant is an employee of the
facility;
(5) periodic oxygen, if
that is all that is required by the recipient;
(6) all transportation in a facility's
vehicle and related to the recipient's care and recreation;
(7) an annual physical examination for a
recipient in a long-term care facility.
(c) The following services are not included in the ICF or SNF all-inclusive rate:
(1)
health care services by providers not employed by the facility or on contract
with the facility to provide services;
(2) personal incidental items authorized for
payment from the recipient's personal incidental allowance or cash
reserve;
(3) nonemergency
continuous heavy use of oxygen as described in
7
AAC 140.580(b); if given prior
authorization by the department, the department will pay the facility the
facility's cost of the oxygen;
(4)
legend drugs and biologicals;
(5)
medical services, including x-ray and laboratory procedures, provided in or out
of a facility by a physician, hospital, or other provider;
(6) essential transportation of a recipient
to and from a source of medical care; the department will pay the carrier
directly for that essential transportation;
(7) transportation for nonmedical reasons in
a vehicle other than the facility's vehicle.
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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