Alaska Administrative Code

(a) If a physician provides behavioral health clinic services in a community behavioral health services provider organization, the physician may request payment for those services by submitting a claim for payment (1) using the community behavioral health services provider's medi…

(a) A mental health professional enrolled under 7 AAC 105.210 and licensed as required in AS 08 who provides behavioral health services under this chapter may only request payment for those services by submitting a claim for payment using the (1) community behavioral health servi…

In this chapter, unless the context requires otherwise. (1) "active treatment" means that the individual who renders the services actively engages the recipient and provides pre-planned specific interventions, supports, or other actions that assist the recipient in achieving the …

The purpose of this chapter is to offer individuals who meet the eligibility criteria of this chapter services offered by the Substance Use Disorder and Behavioral Health Program under the 1115 waiver approved by the United States Department of Health and Human Services, Centers …

In addition to the requirements of 7 AAC 70, 7 AAC 105, and 7 AAC 135, to qualify as a provider of 1115 waiver services, a provider must (1) obtain department certification as an 1115 waiver services provider and identify the 1115 waiver services the provider will provide before …

In this chapter, unless the context requires otherwise, (1) "1115 waiver" has the meaning given in 7 AAC 160.990(b); (2) "community behavioral health services provider" has the meaning given in 7 AAC 70.990; (3) "substance use disorder treatment provider" has the meaning given in…

The following Medicaid-eligible recipients may receive services under this chapter: (1) a child at least 12 years of age and under 18 years of age who may have a substance use disorder, or may be at risk to develop a substance use disorder as determined through a screening conduc…

The department will pay for substance use disorder 1115 waiver services if the (1) recipient is eligible under 7 AAC 138.010; (2) provider meets the requirements in 7 AAC 136.020; (3) Repealed 11/1/2019; (4) provider meets, in addition to the requirements of this chapter, the req…

(a) Except as provided in (b) of this section, the department will pay for a behavioral health Medicaid state plan service provided to an eligible recipient even if the recipient is also receiving services under this chapter. (b) repealed 6/30/2021. Notes 7 AAC 138.030 Eff. 7/1/2…

(a) Substance use disorder 1115 waiver services rates are established in the department's Chart of 1115 Waiver Services, adopted by reference in 7 AAC 160.900. (b) The department will not pay for substance use disorder 1115 waiver services beyond the limits listed in the Alaska B…

The department will pay a provider to (1) conduct an assessment according to 7 AAC 138.020(5) for each recipient receiving substance use disorder services under this chapter; (2) develop an initial treatment plan for each recipient in accordance with 7 AAC 135.120; and (3) review…

(a) The department will pay for a screening conducted by a provider under this chapter if the provider uses (1) one of the department-approved screening tools listed in the Alaska Behavioral Health Provider Service Standards & Administrative Procedures for SUD Provider Services, …

(a) The department will pay for the following outpatient substance use disorder treatment services under the 115 wavier if the service is provided according to this chapter: (1) Intensive outpatient services; (2) partial hospitalization services. (3) outpatient services. (b) Prov…

(a) The department will pay for the following inpatient residential substance use disorder treatment services if the services under the 1115 waiver is provided according to 7 AAC 138.030: (1) clinically managed low-intensity residential services; (2)Repealed 11/10/2019; (3) clini…

(a) The department will pay for the following alcohol and drug withdrawal management services under the 1115 waiver for an adolescent or adult if the service is provided according to 7 AAC 138.020: (1) ambulatory withdrawal management without extended on-site monitoring; (2) ambu…

(a) The department will pay a provider who meets the requirements of 7 AAC 138.020 for one or more of the following substance use disorder 1115 waiver community-based support services provided to an eligible recipient under this chapter: (1) community recovery support services th…

An eligible individual under this chapter who is receiving medication-assisted treatment in an outpatient or inpatient care setting/must also receive substance use disorder care coordination services under the 1115 waiver. Notes 7 AAC 138.410 Eff. 11/10/2019, Register 232, Januar…

(a) The following services may be provided to an eligible recipient under this chapter, as set out in the Alaska Behavioral Health Providers Services Standards & Administrative Procedures for Behavioral Health Provider Services, adopted by reference in 7 AAC 160.900, in any appro…

(a) A provider may only provide the 1115 waiver services listed in this chapter upon approval by the department in accordance with 7 AAC 136.020. (b) A provider must update a recipient treatment plan in accordance with 7 AAC 135.130 before providing a new service listed in this c…

The following individuals may receive services under this chapter: (1) an individual under 21 years of age who (A) is diagnosed with a mental, emotional, or behavioral disorder or substance use disorder; (B) is at risk of developing a mental, emotional, or behavioral disorder or …

The department will pay for behavioral health 1115 waiver services if the (1) recipient is eligible under 7 AAC 139.010; (2) provider meets the requirements in 7 AAC 136.020; (3) services are provided under this chapter; and (4) services are based upon an assessment conducted und…

Notes 7 AAC 139.030 Eff. 5/21/2020, Register 234; am 10/4/2020, Register 236 ; repealed 6/30/2021, Register 238, July 2021 State regulations are updated quarterly; we currently have two versions available. Below is a comparison between our most recent version and the prior quarte…

(a) The behavioral health 1115 waiver services rates are found in the department's Chart of 1115 Medicaid Waiver Services, adopted by reference in 7 AAC 160.900. Click here to view image (b) The department will not pay for a behavioral health 1115 waiver service beyond the limits…

The department will pay a provider to (1) conduct an assessment according to 7 AAC 135.110 for each recipient receiving services under this chapter; (2) develop an initial treatment plan for each recipient under 7 AAC 135.120; and (3) review the treatment plan and revise the plan…

(a) The department will pay for home-based family treatment services according to the following criteria to prevent inpatient hospitalization and residential services for an individual under 21 years of age listed in 7 AAC 139.010(1) if a combination of less intensive outpatient …

(a) The following community-based care management services may be provided to any eligible recipient under this chapter: (1) intensive case management services, that must be provided according to the criteria listed in 7 AAC 138.400(a)(3); (2) community recovery support services,…

Structured treatment services under this section may be provided to a recipient listed in 7 AAC 139.010 if the services are provided according to the following criteria: (1) partial hospitalization program services provided to treat a recipient's assessed psychiatric disorder to …

(a) Adult mental health residential services in this section must be provided in a facility that is approved by the department and that maintains a therapeutically structured and supervised environment according to the criteria listed in the Alaska Behavioral Health Providers Ser…

(a) Children's residential treatment in this section must be provided in a facility approved by the department and that maintains a therapeutically structured and supervised environment according to the criteria listed in the Alaska Behavioral Health Providers Services Standards …

(a) The following services may be provided to an eligible recipient under this chapter, as set out in the Alaska Behavioral Health Providers Services Standards & Administrative Procedures for Behavioral Health Provider Services, adopted by reference in 7 AAC 160.900. in any appro…

The department will pay for therapeutic treatment home services that are provided to an eligible child or adolescent under 7 AAC 139.010(1), who experiences severe mental, emotional, or behavioral health needs that cannot be stabilized in a less intensive home setting. Theraputic…

(a) A provider may only provide the 1115 waiver services listed in this chapter upon approval by the department under 7 AAC 136.020. (b) A provider must update a recipient treatment plan under 7 AAC 135.130 before providing a new service listed in this chapter for a recipient who…

To be eligible for payment under 7 AAC 105 - 7 AAC 160 for ambulatory surgical center services, an ambulatory surgical center must (1) be enrolled in the Medicaid program under 7 AAC 105.210; (2) have a system to transfer recipients requiring emergency admittance or overnight car…

(a) To be covered under 7 AAC 105 - 7 AAC 160, ambulatory surgical center services must be (1) preventive, diagnostic, therapeutic, rehabilitative, or palliative; (2) directly related to a surgical procedure provided to an outpatient by or under the direction of a physician or de…

The department may request a copy of a full operative report, an interpretation of any film, or a pathologist's report on tissue that is removed. When a procedure requires an operative or pathologist's report or particular explanation or interpretation before payment, payment to …

(a) The department will pay a health clinic for services provided to a recipient if the health clinic (1) meets the enrollment and reporting requirements of 42 C.F.R. 405.2400-405.2444, adopted by reference in 7 AAC 160.900; (2) is a federally qualified health center that meets t…

(a) To qualify as a federally qualified health center under 7 AAC 140.200 and this section and for payment under 7 AAC 145.700, a provider must meet at least one of the following eligibility requirements for the entire period for which Medicaid services are rendered: (1) a provid…

To qualify as a rural health clinic under 7 AAC 140.200 and this section and for payment under 7 AAC 145.700, a provider must be an entity that the department has certified under 42 C.F.R. Part 491 as being in compliance with 42 C.F.R. 405.2400 - 405.2417, adopted by reference in…

(a) The department will pay a health clinic for providing services under (b) - (e) of this section rendered to a patient of the clinic by an employee or a contract worker of the clinic. Except as otherwise provided in this section, the department will pay a provider for services …

(a) The department will not pay a health clinic for services provided off-site unless (1) the health clinic patient is homebound as determined under (b) of this section and if all of the following conditions are met: (A) the United States Department of Health and Human Services h…

In 7 AAC 140.200 - 7 AAC 140.229, (1) "ambulatory services" means noninstitutional services that are payable under Medicaid and provided in accordance with this chapter; "ambulatory services" includes (A) visual care; (B) speech; (C) hearing; (D) language; (E) EPSDT; (F) podiatry…

(a) To be eligible for payment under 7 AAC 105 - 7 AAC 160 for providing hospice care services, the provider must (1) be enrolled in the Medicaid program under 7 AAC 105.210; (2) be a public or private organization that the department has certified as a hospice for the purposes o…

(a) Before the department will give prior authorization to and pay for hospice care services provided to a recipient in the recipient's place of residence, the department must receive, no more than eight days after hospice care begins, (1) a certification, signed by the recipient…

(a) Except as otherwise provided in this section, the department may enroll a hospice care provider and pay for hospice care services for a recipient under 21 years of age in the same manner as in 7 AAC 140.270 - 7 AAC 140.275 and 7 AAC 145.690. In addition to satisfying the requ…

In 7 AAC 140.200 - 7 AAC 140.289, (1) "continuous home care" means care provided during a period of crisis in which a recipient requires constant care to reduce or manage acute medical symptoms as necessary to maintain a recipient at home; (2) "general inpatient care" means care …

(a) To be eligible for payment under 7 AAC 105 - 7 AAC 160 for providing hospital services, a provider must (1) be enrolled as a hospital in accordance with 7 AAC 105.210; (2) if located in the state, (A) be licensed under AS 47.32, except for a hospital operated by a tribal heal…

The department will pay for inpatient hospital services only if the (1) recipient is admitted to the hospital by the written order of a physician or other licensed health care professional authorized to admit a patient to a hospital; (2) recipient requires a general acute care ho…