Section 7 AAC 105.140 - Covered services during declared disaster emergency(a) Notwithstanding the provisions of 7 AAC 105.610, 7 AAC 110.750, 7 AAC 120.112, 7 AAC 145.400, and 7 AAC 145.410, the department may make adjustments to covered services listed under (b) of this section for the length of a declared disaster emergency if(1) the governor issues a disaster emergency declaration for the state or a region within the state under AS 26.23.020;(2) the federal government issues a related disaster declaration or declaration of national emergency for the state or a region within the state under 42 U.S.C. 5121- 5207 (Stafford Disaster Relief and Emergency Assistance Act) or 50 U.S.C. 1601- 1651 (National Emergencies Act) and the Secretary of the United States Department of Health and Human Services invokes authority under 42 U.S.C. 1320b-5(b) (sec. 1135(b) of the Social Security Act), with respect to the secretary's declaration of a public health emergency as described under 42 U.S.C. 1320b-5(b) and (g)(1), to waive or modify certain requirements of titles XVIII, XIX, and XXI of the Social Security Act as a result of the disaster declaration; and (3) the state either (A) applies for and receives an approved disaster relief state plan amendment, authorized under 42 U.S.C. 1320b-5, based on the disaster emergency declaration, to make the changes provided for in this section; or(B) has existing state plan authority from CMS to exercise the provisions of (b) of this section during a declared disaster emergency. (b) If the conditions listed in (a) of this section are met, the department may (1) for covered outpatient drugs under 7 AAC 105 - 7 AAC 160, (A) extend the fill duration authorization under 7 AAC 120.112(4) from a 34-day to 68-day supply;(B) increase the professional dispensing fee rates for in-state claims under 7 AAC 145.410(a)(1) and (2) by up to $2.50;(C) increase the professional dispensing fee reimbursement frequency under 7 AAC 145.410(a)(1) and (2) to not more than once every 14 days;(D) allow ingredient reimbursement at actual acquisition cost if the actual acquisition cost is above the lowest determined cost under the formula provided in 7 AAC 145.400 and the provider maintains proof of the actual acquisition cost of the drug consistent with 7 AAC 105.230, substantiated by an unaltered invoice under 7 AAC 105.240; (E) waive the cost-sharing amounts eligible recipients are required to pay under 7 AAC 105.610(a)(4), if the service is related to screening for, diagnosing, or treating the condition at issue in a public health emergency; or(F) waive the requirement under 7 AAC 145.400(j) that a provider return to the pharmacy covered but unused outpatient drugs dispensed in unit doses to a recipient in a long-term care facility, if a public health emergency includes a risk of infection control;(2) for vaccines authorized by the Federal Drug Administration in response to a public health emergency, reimburse providers under 7 AAC 110.750, consistent with 7 AAC 145.020; or(3) reimburse a registered pharmacist acting within the scope of the person's practice under 12 AAC 52 for services consistent with 7 AAC 105-7 AAC 160 and with this subsection during the disaster emergency, including providing testing and other services authorized by a standing order of the chief medical officer when not explicitly defined within the scope of the person's practice.(c) Reimbursements provided for under this section may be requested or disbursed after a declaration of emergency has expired, within standard timely filing under 7 AAC 145.005, for services provided during the emergency. Eff. 2/12/2021,Register 237, April 2021Authority:AS 47.05.010
AS 47.07.030
AS 47.07.040