Section 7 AAC 105.200 - Eligible Medicaid providers(a) Subject to all other requirements of 7 AAC 105 - 7 AAC 160, the following types of providers are eligible to enroll with the department and bill directly for services rendered: (1) a person with an active license under AS 08, or under the laws of the jurisdiction in which the person provides services, to practice as (A) a physician, including an osteopath;(F) a pharmacist or retail pharmacy;(G) a physical therapist;(H) an occupational therapist;(J) a speech-language pathologist;(K) an advanced practice registered nurse;(L) a direct-entry midwife;(P) a hearing aid dealer;(Q) a registered nurse anesthetist; or(S) a clinical social worker;(T) a marital and family therapist;(U) a licensed professional counselor;(V) a licensed dental hygienist who holds an advanced practice permit issued by the Board of Dental Examiners under AS 08.32.125;(2) a facility licensed under AS 47.32, or under the laws of the jurisdiction in which it provides services, to operate as (A) a general acute care hospital or inpatient psychiatric hospital;(B) a long-term care facility;(C) a home health agency;(D) a rural health clinic;(E) an ambulatory surgical center;(F) a hospice care agency;(G) a residential psychiatric treatment center for persons under 22 years of age; or(H) an intermediate care facility for the mentally retarded (ICF/MR);(I) a free-standing birth center;(3) a company or individual not excluded in (b) of this section, supplying (A) medical transportation, ambulance services, oxygen, or eyeglasses;(B) under 7 AAC 120.200 - 7 AAC 120.399, durable medical equipment, medical supplies, prosthetics, orthotics, noncustomized-fabricated orthotics, respiratory therapy, enteral and oral nutritional products, or home infusion therapy; or(C) items paid under 7 AAC 130.305 as specialized medical equipment and supplies;(4) a provider of EPSDT screening services under 7 AAC 110.205;(5) a facility providing services for end-stage renal disease;(6) a personal care agency;(7) a home and community-based waiver services provider, including a provider of environmental modification services under 7 AAC 130.300;(8) a care coordination agency provider, as defined in 7 AAC 130.319;(9) a residential supported-living services provider, as defined in 7 AAC 130.319;(10) a federally qualified health center (FQHC);(11) a tribal health program;(12) a provider of in-state freestanding or portable x-ray services;(13) a provider of behavioral health rehabilitation services under 7 AAC 135.010(c) for a child experiencing a severe emotional disturbance as described in 7 AAC 135.065;(14) a private-duty nursing agency;(15) a school district providing a Medicaid-covered service to a Medicaid recipient;(16) an independent laboratory;(17) an outpatient therapy center;(18) a provider of family planning services;(19) a provider of targeted case management services;(20) a community behavioral health services provider;(21) a mental health physician clinic;(b) Each of the following providers must enroll with the department as a rendering provider, but payment for those services will be made through the rendering provider's supervising health care provider enrolled under this section: (1) a licensed physician assistant;(2) a licensed physical therapy assistant;(3) a licensed occupational therapy assistant;(4) a registered speech-language pathologist assistant;(5) a registered respiratory therapist;(6) a certified respiratory therapy technician;(7) a personal care assistant;(9) a licensed practical nurse who provides direct services to a recipient as an employee of a private-duty nursing agency;(10) a licensed registered nurse who provides direct services to a recipient as an employee of a private-duty nursing agency;(11) a licensed assistant behavior analyst under 7 AAC 135.300;(12) an autism behavior technician under 7 AAC 135.300.(c) Notwithstanding any other provision of 7 AAC 105 - 7 AAC 160, and if the employee has an active license from a jurisdiction in the United States, a health care provider who is an employee of the federal government assigned to a tribal health program is exempt from any requirement in 7 AAC 105 - 7 AAC 160 that the provider be licensed, certified, or registered by this state to be eligible under this section.(d) Notwithstanding any other provision of 7 AAC 105 - 7 AAC 160, a hospital, clinic, or other type of health care facility that is operated by a tribal health program is exempt from a requirement in 7 AAC 105 - 7 AAC 160 that the provider be licensed or certified by this state to be eligible under this section.(e) If a rendering provider identified in (b) of this section is an employee of or under contract with an enrolled tribal health program, that tribal health program is the supervising health care provider of that rendering provider for the purposes of receiving payment under 7 AAC 105 - 7 AAC 160.Eff. 2/1/2010, Register 193; am 10/1/2011, Register 199; am 5/1/2016, Register 218, July 2016; am 6/16/2016, Register 218, July 2016; am 7/1/2018, Register 226, July 2018; am 6/2/2019, Register 230, May 2019; am 4/24/2020, Register 234, April 2020; am 7/8/2020, Register 235, October 2020; am 8/27/2021, Register 239, October 2021; am 3/1/2024, Register 249, April 2024Authority:AS 47.05.010
AS 47.07.030
AS 47.07.040