Section 7 AAC 145.750 - Supplemental emergency medical transportation (SEMT) program(a) The supplemental emergency medical transportation (SEMT) program is a voluntary program that makes supplemental payments to publicly owned or operated SEMT providers that provide qualifying emergency medical transportation services to Medicaid recipients. The supplemental payment covers the gap between the eligible SEMT provider's total allowable costs for providing SEMT services as reported on the Supplemental Emergency Medical Transportation (SEMT) Cost Report, adopted by reference in 7 AAC 160.900, and the amount of the base payment, mileage, and all other sources of reimbursement.(b) The department will make supplemental payments only up to the amount uncompensated by all other sources of reimbursement for the SEMT services provided to applicable Medicaid recipients. The total reimbursement, including the fee-for-service Medicaid payment, third party liability payment, and SEMT payment, may not exceed 100 percent of actual costs.(c) A supplemental payment does not increase the current Medicaid fee-for-service (FFS) reimbursement rates. A participating provider shall continue to bill for the applicable FFS services and will be paid at the rates listed in the Transportation/Accommodation Fee Schedule adopted by reference in 7 AAC 160.900. The supplemental payment includes only SEMT services provided to FFS Medicaid recipients by eligible SEMT providers for dates of service on or after August 31, 2019.(d) The SEMT program is only available for transportation of FFS Medicaid recipients who are currently eligible under 42 U.S.C. 1396- 1396w-6 (Title XIX of the Social Security Act), under 42 U.S.C. 1397aa- 1397mm (Title XXI of the Social Security Act), under P.L. 111-148 (Patient Protection and Affordable Care Act), or through the Indian Health Service established under 25 U.S.C. 1661. A participating provider may not receive supplemental payments for transporting (1) Medicaid applicants; or(2) Medicare recipients with dual eligibility for Medicaid.(e) The state general fund is not available for SEMT supplemental payments.Click here to view image
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Eff. 10/9/2021, Register 240, January 2022Authority:AS 47.05.010
AS 47.07.040
AS 47.07.085