Section 7 AAC 105.120 - Out-of-state covered services(a) Unless otherwise provided in 7 AAC 105 - 7 AAC 160, the department will cover a service provided out of state to the same extent it would cover the service provided in this state if (1) the service is provided to a recipient who is a resident of this state; and(2) the department is able to verify one of the following situations: (A) the recipient requires a medical service that is not available in this state or the provision of that service out of state is more cost-effective;(B) the medical service is needed due to a medical emergency while a recipient is out of state and the recipient's health would be endangered if the recipient were required to travel to this state for the needed medical service;(C) laboratory specimens are sent out of state because (i) the laboratory service is not offered in this state;(ii) the laboratory service is more readily available out of state; or(iii) to have the laboratory work performed out of state is more cost-effective.(b) The department may pay an out-of-state provider for a service provided to a recipient from this state that meets the requirements of (a) of this section if the provider (1) is enrolled in the Medicaid program in this state;(2) is enrolled in the Medicaid program in the jurisdiction where the service is provided; and(3) possesses the appropriate license in the other jurisdiction to provide the required service.(c) The department may deny a request for a service provided out of state that requires prior authorization by the department if the requirements of (a) of this section are not met.(d) An inpatient psychiatric hospital, psychiatric facility, and a residential psychiatric treatment center may be approved by the department as a provider, if the department determines that a need exists for the service under (a)(2) of this section.Eff. 2/1/2010, Register 193; am 10/1/2011, Register 199Authority:AS 47.05.010
AS 47.07.030
AS 47.07.032
AS 47.07.040