7 AAC 110.400 - Physician services provider enrollment requirements
(a) To be eligible
for payment under 7 AAC 105 - 7 AAC 160 for providing physician services, the
provider must
(1) be enrolled as a physician
in accordance with
7
AAC 105.210; and
(2) have an active license to practice
medicine or osteopathy issued by the jurisdiction in which the physician
provides services; if services are provided in this state the individual must
hold an active license under AS 08.64.
(b) To be eligible for payment under 7 AAC
105 - 7 AAC 160 for providing physician services in a group practice, the group
must
(1) be enrolled in accordance with
7
AAC 105.210; and
(2) be comprised of one or more individuals
who meet the requirements of (a) of this section.
(c) In addition to meeting the requirements
of (a) of this section, to be eligible for payment for laboratory services
performed in the physician's own laboratory, a physician must have a CMS
Clinical Laboratory Improvement Amendments (CLIA) certificate of waiver under
42 C.F.R.
493.35 -
493.37 or a registration
certificate under 42. C.F.R. 493.43 - 493.45. A copy of the CLIA certificate of
waiver or registration certificate must be submitted with the application for
enrollment under
7
AAC 105.210.
(d) In addition to meeting the requirements
of (a) of this section, to be eligible for payment for dispensing prescription
drugs, a physician must enroll as a dispensing provider under
7
AAC 120.100.
(e) A hospital-based physician must be
individually enrolled as a physician under this section.
Notes
Authority:AS 47.05.010
AS 47.07.030
AS 47.07.040
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