7 AAC 145.640 - Nursing facility payment rates
(a) Except as
otherwise provided in this section, the department will pay for services
rendered by an intermediate care facility (ICF) or skilled nursing facility
(SNF) at the all-inclusive rate determined in accordance with 7 AAC 150, less
the cost-of-care liability determined under
7
AAC 100.554.
(b) Partial payment may be made to a nursing
facility upon request. Partial payment may be made monthly in an amount not to
exceed 80 percent of the average monthly billing for the previous state fiscal
quarter.
(c) A recipient's income
is a prior resource. If a recipient remains in a nursing facility for a period
of less than a full month, the recipient's income for the month, after
subtracting all allowable deductions, must be divided by the number of days in
the month and that daily amount applied to those days that the recipient was in
the nursing facility.
(d) The
department will pay an out-of-state nursing facility at the Medicaid rate used
by the jurisdiction where the facility is located.
(e) Payment by the department is payment in
full for those services authorized under Medicaid. If the nursing facility
obtains from another source any additional payment for the care provided to a
recipient for services that have been paid for by Medicaid, the facility shall
refund or credit the additional payments to the department.
(f) A nursing facility may not submit a claim
for payment that exceeds the rate charged to a private client for any item or
service charged by the facility.
Notes
Authority:AS 47.05.010
AS 47.07.030
AS 47.07.040
AS 47.07.070
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