Section 7 AAC 145.650 - ICF and SNF all-inclusive rates(a) The rate established for an intermediate care facility or a skilled nursing facility includes all services, supplies, and equipment required for complete care, except as otherwise provided in this section.(b) The following services are included in the ICF or SNF all-inclusive rate and will not be paid for separately: (1) rehabilitative nursing care, including service of restorative aides and nurses, as part of nursing and supportive care services;(2) nonprescription drugs;(3) direct physical or occupational therapy services to an individual recipient, prescribed by a physician;(4) consultation, training, and other nondirect recipient care services by a physical therapist, physical therapy assistant, occupational therapist, or occupational therapy assistant, whether or not the therapist or assistant is an employee of the facility;(5) periodic oxygen, if that is all that is required by the recipient;(6) all transportation in a facility's vehicle and related to the recipient's care and recreation;(7) an annual physical examination for a recipient in a long-term care facility.(c) The following services are not included in the ICF or SNF all-inclusive rate:(1) health care services by providers not employed by the facility or on contract with the facility to provide services;(2) personal incidental items authorized for payment from the recipient's personal incidental allowance or cash reserve;(3) nonemergency continuous heavy use of oxygen as described in 7 AAC 140.580(b); if given prior authorization by the department, the department will pay the facility the facility's cost of the oxygen;(4) legend drugs and biologicals;(5) medical services, including x-ray and laboratory procedures, provided in or out of a facility by a physician, hospital, or other provider;(6) essential transportation of a recipient to and from a source of medical care; the department will pay the carrier directly for that essential transportation;(7) transportation for nonmedical reasons in a vehicle other than the facility's vehicle.Eff. 2/1/2010, Register 193Authority:AS 47.05.010
AS 47.07.030
AS 47.07.040
AS 47.07.070