Section 7 AAC 140.700 - End-stage renal disease facility enrollment requirements(a) To be eligible for payment under 7 AAC 105 - 7 AAC 160 for outpatient end-stage renal disease services, a provider must(1) be enrolled as an end-stage renal disease services facility in accordance with 7 AAC 105.210;(2) meet the requirements of 42 C.F.R. Part 494 (conditions for coverage for end-stage renal disease facilities), adopted by reference in 7 AAC 160.900; and(3) be enrolled as a Medicare provider.(b) If a provider operates end-stage renal disease facilities at more than one site, each site must enroll separately and meet the requirements of this section.(c) On or before the last day of the sixth month after the close of its fiscal year, each end-stage renal disease facility that is enrolled in this state's Medicaid program shall submit an annual report to the department. The annual year-end report is required even if the clinic did not provide medical services to Medicaid recipients during that fiscal year. The annual year-end report must include the following: (1) the most recent uniform Medicare cost report submitted by the facility to the facility's Medicare fiscal intermediary, including (A) any supporting schedules submitted with, or in support of, the facility's Medicare cost report that were transmitted to the Medicare fiscal intermediary; (B) audited financial statements that include financial information specific to the reporting facility for the time period that matches the submitted Medicare cost report; the submission must also include any audit adjustments made by the financial statement auditors; (C) reconciliation of the audited financial statements to Worksheet A of the submitted Medicare cost report; (D) the facility's post-audit working trial balance; and (E) reconciliation of the post-audit working trial balance to Worksheet A of the Medicare cost report; and (2) appropriate Medicaid Form E-1-reporting forms, adopted by reference in 7 AAC 160.900. (d) If an end-stage renal disease facility receives an extension for timely filing a Medicare cost report from the facility's Medicare fiscal intermediary, the facility must forward to the department, not later than 30 days after the date on the letter, a copy of the Medicare fiscal intermediary's letter that grants the extension. After receipt of the letter, the department will grant a corresponding extension for the facility's year-end report. (e) Each annual year-end report will be date-stamped upon receipt by the department. The department will acknowledge the date of receipt in a notice to the provider. Not later than 20 days after receipt of an annual year-end report, the department will review the report to determine whether the submission is complete. Once the review has been completed, (1) the department will send a notice to the facility that the annual year-end report is incomplete; (2) the department will clearly identify in the notice the deficiencies and the time not later than which the department must receive the corrected or modified annual year-end report; the department will give the facility at least seven days following receipt of the notice to submit the corrected or modified annual year-end report to the department; and (3) if a notice is not sent to the provider within the 20-day period, the department will treat the annual year-end report as complete. (f) The department may conduct audits, perform special analysis, and review the records of an end-stage renal disease facility to verify compliance with Medicare and Medicaid regulations. A facility shall provide to the department financial and all other information regarding Medicaid claims for services provided by the facility to eligible recipients and shall provide access to all facility locations and records as requested by the department. (g) If a facility fails to submit the annual year-end report, or if the department determines the report to be incomplete and not corrected or modified as required under (e) of this section, the department will withhold two percent of any payment due to the facility until the end of the fiscal quarter that the report is submitted and determined complete. The department will begin withholding two percent of the treatment payment on the 30th day following the date the complete annual report is due. (h) The department will provide notice under this section by means of electronic mail. However, if there is no electronic mail account associated with the provider's enrollment, the department will provide notice by means of United States mail.Eff. 4/1/2012, Register 201; am 3/24/2019, Register 229, April 2019Authority:AS 47.05.010
AS 47.07.030
AS 47.07.040
AS 47.07.070