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

   1. (1) be enrolled as a hospital in accordance with 7 AAC 105.210;

   2. (2) if located in the state,

      1. (A) be licensed under AS 47.32, except for a hospital operated by a tribal health program; and
      2. (B) comply with the requirements of 7 AAC 150;
   3. (3) if located out of state, meet all applicable licensing and accreditation requirements of the jurisdiction in which the hospital is located;
   4. (4) have a department-approved plan of utilization review; and
   5. (5) comply with all prior authorization requirements established under 7 AAC 105 - 7 AAC 160.
2. (b) The provisions of 7 AAC 140.300 - 7 AAC 140.325 apply to all general acute care hospital services, including inpatient, outpatient, and emergency room services. Except as otherwise provided in 7 AAC 105 - 7 AAC 160, 7 AAC 140.300 - 7 AAC 140.325 do not apply to inpatient or outpatient psychiatric facility or residential psychiatric treatment center services.

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

Authority: AS 47.05.010, AS 47.07.030, AS 47.07.040