For a nursing facility to be eligible for payment under 7 AAC 105 - 7 AAC 160 for providing nursing facility services, the following requirements must be met:

1. (1) the nursing facility must

   1. (A) be enrolled with the department under 7 AAC 105.210 as an intermediate care facility or skilled nursing facility;
   2. (B) if located out of state, be enrolled in the Medicaid program in the jurisdiction where services are provided;
   3. (C) meet all federal utilization control and Medicare long-term care facility requirements under 42 C.F.R. Part 456 and 42 C.F.R. Part 483, adopted by reference in 7 AAC 160.900; and
   4. (D) meet all certification and licensing requirements of the jurisdiction in which the nursing facility is located; if located in this state, the nursing facility must be licensed and certified under AS 47.32;
2. (2) the department has determined under 7 AAC 140.505 that the recipient's medical needs require the level of care that the nursing facility is certified to provide;
3. (3) the department has given prior authorization to the recipient's placement in the nursing facility.

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

Authority: AS 47.05.010, AS 47.07.030, AS 47.07.040, AS 47.07.070