Sec. 47.25.195. Payment to facilities for treatment of needy persons.

395 words·~2 min read·/ak/title-47/chapter-25/47-25-195

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(a)The department may make payments to a health facility for the treatment of a needy person.

(b)Except as provided in

(e)of this section, a health facility receiving a payment under this chapter is subject to the requirements of AS 47.07.070 — 47.07.075.

(c)Except as provided in

(e)of this section, if insufficient money is appropriated to fund medical assistance under AS 47.25.120 — 47.25.300 when taking into consideration projected use and the health facility payment rates established in accordance with

(b)of this section, the department may, by regulation, establish at any time in the fiscal year a prospective pro rata reduction of the facilities' established payment rates that will be paid by the department for services provided by facilities under AS 47.25.120 — 47.25.300.

(d)Notwithstanding

(a)—

(c)of this section, the department may enter into agreements with a facility to provide services at a payment rate lower than the rate established in accordance with

(b)of this section, except that the department may not enter into an agreement with an assisted living home to provide services at a daily reimbursement rate lower than $70.

(e)Notwithstanding other provisions of this section and the provisions of AS 47.07 , if the assistance provided to a needy person under AS 47.25.120 — 47.25.300 includes the initiation or continuation of placement of the person in an assisted living home at the state's expense, the department's minimum daily reimbursement rate to the assisted living home for the person is $70. This minimum rate is not subject to reduction under

(c)of this section. The department may, under its regulations and under the procedures of AS 47.07.070 — 47.07.075, provide for a daily rate higher than $70 if the care provided to the needy person in the assisted living home justifies the higher reimbursement. A daily rate higher than $70 for assisted living homes may be reduced under

(c)of this section, but not below $70.

(f)For purposes of this section,

(1)“assisted living home” means an assisted living home licensed under AS 47.32 ;

(2)“health facility” includes a hospital, skilled nursing facility, intermediate care facility, intermediate care facility for persons with intellectual and developmental disabilities, rehabilitation facility, inpatient psychiatric facility, home health agency, rural health clinic, and outpatient surgical clinic.