Section 7 AAC 135.030 - Behavioral health provider enrollment and organization(a) To be eligible for payment under 7 AAC 135.010 - 7 AAC 135.370 for providing Medicaid behavioral health services, a provider must be enrolled in Medicaid under 7 AAC 105.210 and must be either (1) a community behavioral health services provider;(2) a mental health physician clinic that meets the requirements of (d) of this section;(3) a psychologist who (A) meets the requirements of 7 AAC 110.550; and(B) provides psychological testing and evaluation under 7 AAC 135.110(g);(4) a licensed behavior analyst who (A) meets the requirements of 7 AAC 135.300; and(B) provides autism services under 7 AAC 135.350; or(5) a licensed behavior analyst group practice that (A) meets the requirements of 7 AAC 135.300; and(B) provides autism services under 7 AAC 135.350.(6) a licensed mental health professional who meets the requirements of 7 AAC 135.910.(b) If a community behavioral health services provider is administratively, organizationally, financially, or otherwise connected to a health facility, as defined in AS 47.07.900, the community behavioral health services provider must account for income and expenses separately from the health facility to verify that the cost used by the department to determine the health facility's prospective payment rate under 7 AAC 150 is excluded from the operating cost of the community behavioral health services provider.(c) If a community behavioral health services provider is operated by a governmental or corporate entity that concurrently operates a health facility, the health facility may provide administrative and other support services to the community behavioral health services provider. However, the department will not include the cost of providing those behavioral health services in determining the health facility's prospective payment rate under 7 AAC 150. If a physician or other health professional is employed by the health facility and by the community behavioral health services provider, the physician or other health professional must be employed under a separate written agreement with the community behavioral health services provider that requires that the cost of services provided by the physician or other health care professional be (1) separately accounted for by the community behavioral health services provider; and(2) excluded from the costs considered by the department in determining the health facility's prospective payment rate under 7 AAC 150.(d) The department will pay for behavioral health clinic services provided by a mental health physician clinic only if the(1) mental health physician clinic is operated by one or more physicians licensed under AS 08.64 who provide direct supervision under AS 47.07.030(g) to all clinic employees and to individuals on contract with the clinic to provide behavioral health clinic services;(2) services are for treatment of a diagnosable mental health disorder;(3) services are provided by one of the physicians operating the clinic or by one of the following individuals who work under the direct supervision of those physicians: (A) a psychologist who is licensed under 7 AAC 110.550;(B) a psychological associate who is licensed under AS 08.86 or in the jurisdiction where services are provided, and who renders the services within the scope of practice identified in 12 AAC 60;(C) a clinical social worker who is licensed under AS 08.95;(D) a physician assistant who is licensed under 7 AAC 110.455;(E) an advanced practice registered who is licensed and certified as required under 7 AAC 110.100;(F) a psychiatric nursing clinical specialist who is licensed under AS 08.68 or in the jurisdiction where services are provided;(G) a marital and family therapist who is licensed under AS 08.63 or in a jurisdiction with requirements substantially similar to the requirements of AS 08.63 where services are provided; or(H) a professional counselor who is licensed under AS 08.29 or in a jurisdiction with requirements substantially similar to the requirements of AS 08.29 where services are provided; and(4) services are provided on the premises of the mental health physician clinic or by means of a telehealth modality under 7 AAC 110.620 - 7 AAC 110.639, unless the service is provided to a person experiencing homelessness.Eff. 10/1/2011, Register 199; am 7/1/2018, Register 226, July 2018; am 11/10/2019, Register 232, January 2020; am 4/24/2020, Register 234, April 2020; am 9/1/2023, Register 247, October 2023; am 2/2/2024, Register 249, April 2024Authority:AS 47.05.010
AS 47.07.030
AS 47.07.069