1. (a) To be eligible for payment under 7 AAC 105 - 7 AAC 160 for providing physician services, the provider must

   1. (1) be enrolled as a physician in accordance with 7 AAC 105.210; and
   2. (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.

2. (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. (1) be enrolled in accordance with 7 AAC 105.210; and
   2. (2) be comprised of one or more individuals who meet the requirements of (a) of this section.
3. (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.
4. (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.
5. (e) A hospital-based physician must be individually enrolled as a physician under this section.

(Eff. 2/1/2010, Register 193)

Authority: AS 47.05.010, AS 47.07.030, AS 47.07.040