7 Alaska Admin. Code § 120.405

Current through September 25, 2024
Section 7 AAC 120.405 - Transportation and accommodation covered services
(a) The department will pay a provider for only those transportation and accommodation services that are
(1) provided to assist the recipient in receiving medically necessary services; and
(2) authorized by the department under 7 AAC 120.410 and 7 AAC 120.415.
(b) The department will approve nonemergency transportation and accommodation services outside the recipient's community of residence to obtain medically necessary services covered under? AAC 105 -7 AAC 160 for the recipient if the prior authorization requirements of AAC 120.410 are met and
(1) those services are not available in the recipient's community;
(2) the total cost for Medicaid services with transportation and accommodation costs included is less than the cost of the services at a facility within the recipient's community of residence; or
(3) the recipient is an American Indian or Alaska Native who has requested services from a tribal health program outside the recipient's community of residence.
(c) The department will not pay for
(1) transportation or accommodations that the department determines to be excessive or inappropriate for the distance traveled or inconsistent with the medical needs of the recipient;
(2) transportation for a recipient two years of age or younger if the department pays the cost for an escort to accompany the child, unless the condition of the child prevents the child from riding in the same seat as the escort;
(3) transportation for a recipient who is an inpatient in a general acute care hospital and who is being transported to another location to receive medical services if the recipient remains a recipient in the general acute care hospital while absent and is to be returned to the general acute care hospital;
(4) except as provided in 7 AAC 120.415(a), transportation for a recipient or an authorized escort to travel to receive services from a provider that is not enrolled as a Medicaid provider under 7 AAC 105- 7AAC160 at the time the travel occurs, unless the provider is a military or veterans' facility;
(5) transportation and accommodations on weekends if
(A) travel on a weekday would shorten the length of the trip;
(B) the department did not give prior authorization for the weekend travel; or
(C) the weekend travel is not medically necessary; or
(6) separate accommodations for a recipient and escort, unless the department determines that the circumstances warrant separate accommodations.
(d) The department will pay for nonemergency ground ambulance services if it is warranted by the recipient's medical condition. Nonemergency ground ambulance services are paid at an all-inclusive rate established by the department. The department will not make an additional payment for oxygen or other basic support items associated with the travel by nonemergency ground ambulance services.
(e) The department will not reimburse a recipient for transportation and accommodation services paid for by the recipient or by an individual or entity on behalf of the recipient.

7 AAC 120.405

Eff. 2/1/2010, Register 193; am 5/1/2016, Register 218, July 2016 ; am 7/1/2020,Register 234, July 2020

Authority:AS 47.05.010

AS 47.07.030

AS 47.07.040