7 AAC 145.770 - SEMT interim supplemental payment
(a) For SEMT, the
department will pay an interim supplemental payment that approximates the SEMT
costs eligible for federal financial participation claimed through the
certified public expenditure (CPE) process.
(b) The department will calculate the interim
supplemental payment rate for SEMT on an annual basis per cost report. The
department will pay one interim payment not later than the end of the second
quarter following the cost report submission.
(c) The department will determine the interim
supplemental payments using the most recently filed cost reports provided under
7
AAC 145.760. The cost reports will be used to
determine an average cost per qualifying medical transport, using the following
calculation:
(1) the sum of a participating
provider's allowable direct and indirect costs for ground, air, and water
medical transport services will be divided by the number of medical transports,
separated into ground, air, and water services by the service-specific
components, to determine a participating provider's average cost per medical
transport for each ground, air, or water service;
(2) the average cost per medical transport
for each ground, air, or water service will be multiplied by the number of
qualifying Medicaid fee-for-service emergency medical transports to determine
allowable Medicaid emergency medical transportation costs;
(3) the allowable Medicaid emergency medical
transportation costs will be offset by Medicaid revenue for fee-for-service
(FFS) and third party liability (TPL) for Medicaid emergency medical
transports, to calculate the Medicaid emergency medical transportation costs
that have not been paid by any other source;
(4) the calculated Medicaid emergency medical
transportation costs not paid by any other source will be multiplied by the
federal medical assistance percentage (FMAP), within the meaning given in
42
U.S.C. 1396d(b) (sec.
1905(b), Title XIX, Social Security Act), to determine the interim
payment.
(d) The cost per
medical transport per participating provider utilizes provider-specific data
and varies from provider to provider. The department will calculate the amount
of interim supplemental payments among the participating providers, in varying
amounts based on the provider-specific data.
Notes
Authority:AS 47.05.010
AS 47.07.040
AS 47.07.085
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