Sec. 21.09.242. Cooperation with the Department of Health.

343 words·~2 min read·/ak/title-21/chapter-9/21-09-242

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(a)An insurer, including a pharmacy benefits manager, with respect to medical assistance programs under AS 47.07 , shall cooperate with the Department of Health to

(1)provide, with respect to an individual who is eligible for or is provided medical assistance under AS 47.07 , on the request of the department, information to determine during what period the individual or the individual's spouse or dependents may be or may have been covered by the insurer and the nature of the coverage that is or was provided by the insurer, including the name and address of the insurer and the identifying number of the health care insurance plan;

(2)accept the department's right of recovery and the assignment to the department of any right of an individual or other entity to payment from the party for an item or service for which payment has been made under AS 47.07 ;

(3)respond to any inquiry by the department regarding a claim for payment for any health care item or service that is submitted not later than three years after the date of the provision of the health care item or service; and

(4)agree not to deny a claim submitted by the department solely on the basis of the date of submission of the claim, the type or format of the claim form, or a failure to present proper documentation at the point-of-sale that is the basis of the claim if

(A)the claim is submitted by the department within the three-year period beginning on the date on which the item or service was furnished; and

(B)any action by the department to enforce its rights with respect to the claim is commenced within six years after the department's submission of the claim.

(b)An assessable entity, as defined in AS 18.09.990 , shall provide information and assessments to the Department of Health and the State Vaccine Assessment Council established under AS 18.09.210 as necessary for the statewide immunization program established under AS 18.09.200 .