Section 7 AAC 53.320 - Medical, dental, diagnostic, and therapeutic services(a) The parents of a child in department custody are expected to be responsible for necessary medical, dental, diagnostic, and therapeutic services for the child.(b) If the child is eligible to receive Medicaid benefits, payment for the medical, dental, diagnostic, and therapeutic care of a child placed in an out-of-home care setting by the department will be made through the Medicaid program. The proof of Medicaid eligibility must be furnished to the medical provider by the out-of-home care provider to enable the medical provider to bill the Department of Health for services rendered.(c) The department is financially responsible for routine medical, dental, diagnostic, and therapeutic services for a child placed in an out-of-home care setting who is not eligible under the Medicaid program and who has no other resources, such as a military health benefit, the Alaska Native Health Service, or the child's parents, to meet these needs. The department will not cover medical costs higher than the established Medicaid rates. The department, in consultation with the Department of Health, will use the Medicaid criteria and rates to determine whether it will cover the requested medical services. The medical provider may bill the department directly for these services. Prior authorization from the Department of Health under 7 AAC 105 - 7 AAC 160 is required.(d) An out-of-home care provider is expected to obtain routine medical and dental care for a child in accordance with 7 AAC 50.455. The out-of-home care provider must receive prior authorization from the Department of Health under 7 AAC 105 - 7 AAC 160 before nonemergency or nonmedically necessary services are provided. A service will not be reimbursed by Medicaid unless it is medically necessary under 7 AAC 105 - 7 AAC 160 and the Department of Health has provided prior authorization consistent with the child's placement plan.(e) For emergency medical and dental treatment, the out-of-home care provider may seek treatment immediately without prior authorization, but must notify the Department of Family and Community Services and the Department of Health.Eff. 11/23/78, Register 68; am 7/1/90, Register 114; am 1/1/96, Register 136; am 4/13/2011, Register 198; am 7/1/2022, Register 242, July 2022Authority:AS 47.05.010
AS 47.06.010
AS 47.10.080
AS 47.14.010