Section 47.08.070. Standards for reimbursement to providers.

The amount that the committee reimburses providers for medical services rendered to a person who has suffered catastrophic illness may not be greater than 100 percent of the total unpaid bills related to the catastrophic illness and shall be determined by the following standards:
        (1) only unpaid medical expenses for periods not to exceed 12 months, and related to catastrophic illness, may be considered;  the initial 12-month period begins with the date of the first charges incurred because of the illness;
        (2) the committee may not reimburse a provider if the applicant's total medical expenses related to the catastrophic illness are less than $1,000 in any period not exceeding 12 months described in (1) of this section after all sources of third-party payment have been exhausted by the applicant or by someone acting on behalf of the applicant;
        (3) the committee may not reimburse a provider for the applicant's share of the total medical expenses; moreover, a reimbursement to the provider shall be conditioned on the provider's agreement that the provider enter into a payment schedule with the applicant which will result in full liquidation of the applicant's share; payment schedules may not be for a term of less than three years.

Notes

Implemented As

7 AAC 48.080

History

(Sec. 1 ch 107 SLA 1978)