Section 7 AAC 140.220 - Health clinic services provided off-site(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 has determined that a shortage of home health agencies exists in the area;(B) services are furnished by a registered nurse, a licensed practical nurse, or a licensed vocational nurse who is employed by, or receives compensation for the services from, the clinic;(C) the services are furnished under a written plan of treatment that is (i) established and reviewed at least every 60 days by a supervising physician of the health clinic or established by an advanced practice registered nurse or a physician assistant and reviewed at least every 60 days by a supervising physician; and(ii) signed by the advanced nurse practitioner, the physician assistant, or the supervising physician of the health clinic;(D) the nursing care coverage is limited as specified in 42 C.F.R. 405.2416(b) and (c), adopted by reference in 7 AAC 160.900;(2) a rural health clinic physician, acting within the scope of the physician's license to practice, provides the services in a hospital or nursing facility;(3) a rural health clinic physician assistant or rural health clinic advanced practice registered nurse, acting within the scope of that individual's license to practice, provides the services in a hospital; or(4) a federally qualified health center physician, physician assistant, or advanced practice registered nurse, acting within the scope of the individual's license to practice, provides the services in a nursing facility.(b) A health clinic patient is homebound if, due to the individual's medical or health condition, the individual is confined to the individual's residence, or cannot leave the residence without considerable effort. The department will not disqualify an individual from being considered homebound for infrequent absences of short duration from the residence, including absences to attend religious services, or for absences from the residence in order to receive health care treatment, including participation in therapeutic or medical treatment as part of adult day services provided under 7 AAC 130.250 by a provider that is certified under 7 AAC 130.220. The department will not consider an individual to be homebound if the individual's residence is a hospital or long-term care facility.(c) This section does not apply to a federally qualified health center. Eff. 2/1/2010, Register 193; am 4/24/2020, Register 234, April 2020; am 11/1/2021, Register 240, January 2022Authority:AS 47.05.010
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