Section 7 AAC 105.100 - Covered servicesThe department will pay for a service only if that service
(1) is identified as a covered service in accordance with AS 47.07 and 7 AAC 105 - 7 AAC 160;(2) is provided to an individual who is eligible for Medicaid under 7 AAC 100 on the date of service;(3) is ordered or prescribed by a provider authorized to order or prescribe that service under applicable law;(4) is provided by a person who is enrolled as a Medicaid provider or rendering provider under 7 AAC 105.210, or otherwise eligible to receive payment for services under 7 AAC 105 - 7 AAC 160;(5) is medically necessary as determined by criteria established under 7 AAC 105 - 7 AAC 160 or by the standards of practice applicable to the provider;(6) has received prior authorization from the department, if prior authorization is required under 7 AAC 105 - 7 AAC 160; and(7) is not specifically excluded as a noncovered service under 7 AAC 105 - 7 AAC 160.Eff. 2/1/2010, Register 193; am 10/1/2011, Register 199Authority:AS 47.05.010
AS 47.07.030
AS 47.07.040