Section 7 AAC 145.580 - Behavioral health services payment rates(a) The department will pay a corresponding unit of service for providing community behavioral health services under 7 AAC 135.100 - 7 AAC 135.280, at the lesser of the following rates: Click here to view image
(1) the amount charged by the provider in accordance with 7 AAC 145.020; or(2) the rate established in the department's Chart of Community Behavioral Health Services Medicaid Rates, adopted by reference in 7 AAC 160.900; for state fiscal year 2020, the payment rates will be 95 percent of the state fiscal year 2019 payment rates.(b) On or after July 1, 2018, rates of payment in the department's Chart of Community Behavioral Health Services Medicaid Rates, adopted by reference in 7 AAC 160.900, will be reestablished at least every four years using a modeled rate methodology that includes components for salaries, fringe benefits, productivity, program support, administrative/general costs, and duration of units of service. Other sources that will be used in the modeled rate methodology include information from the Department of Labor and Workforce Development, Research and Analysis Section; the United States Internal Revenue Service; and provider surveys.(c) Each July 1, except July i, 2019, that rates of payment in the Chart of Community Behavioral Health and Mental Health Physician Clinic Medicaid Covered Services Rates, adopted by reference in 7 AAC 160.900, are not reestablished under (b) of this section, the department will adjust the rates of payment in the Chart of Community Behavioral Health and Mental Health Physician Clinic Medicaid Covered Services Rates for Inflation using the CMS Home Health Agency Market Basket in the in post recent quarterly publication of the IHS Markit Healthcare Cost Review available 60 days before July 1.(d) The department will pay a corresponding unit of service for providing autism services under 7 AAC 135.350 at the lesser of the following rates: (1) the amount charged by the provider in accordance with 7 AAC 145.020; or(2) the rate established in the department's Medicaid Procedure Codes and Rates - Autism Services, adopted by reference in 7 AAC 160.900.(f) Each July 1, the department will adjust the rates of payment in the Medicaid Procedure Codes and Rates - Autism Services, adopted by reference in 7 AAC 160.900. for inflation using the CMS Home Health Agency Market Basket in the most recent quarterly publication of the IHS Markit Healthcare Cost Review available 60 days before July 1.Eff. 2/1/2010, Register 193; am 10/1/2011, Register 199; am 4/9/2017, Register 222, July 2017; am 5/21/2017, Register 222, July 2017; am 7/1/2018, Register 226, July 2018; am 1/1/2019, Register 228, January 2019; am 7/1/2019, Register 231, January 2019; am 10/25/2019, Register 232; am 4/24/2020, Register 234, April 2020; am 6/30/2021, Register 238, July 2021; am 5/25/2022, Register 242, July 2022; am 2/2/2024, Register 249, April 2024Authority:AS 47.05.010
AS 47.07.030
AS 47.07.040