NOTICE OF PROPOSED CHANGES ON THE 72 HOUR DOCUMENTATION REQUIREMENT AND PROVIDER SELF-AUDITS IN THE REGULATIONS OF THE DEPARTMENT OF HEALTH & SOCIAL SERVICES

The Department of Health & Social Services proposes to adopt regulation changes in Title 7 of the Alaska Administrative Code, dealing with the Medicaid provider 72 hour documentation rule and provider self-audits, including the following:

• 7 AAC 105.230. Medicaid Provider and Recipient Participation; Requirements for provider records, is proposed to be changed as follows:
  • Adopt a 14-days documentation standard for all providers.
  • Clarify what is considered a time based code to maintain start and stop times.
  • Reduce record keeping requirements for evaluation and management codes.

   

• 7 AAC 160.115. Medicaid Program; General Provisions; Duty of a provider to identify and repay self-identified overpayments, is proposed to be changed as follows:
  • Adopt the Medicare definition of "identified" for a provider to return an overpayment.
  • Clarify what a provider self-audit report must contain.

You may comment on the proposed regulation changes, including the potential costs to private persons of complying with the proposed changes, by submitting written comments to Mr. Doug Jones at 4501 Business Park Blvd., Ste. 24, Building L, Anchorage, AK 99503. Additionally, the Department of Health & Social Services will accept comments by facsimile at (907) 269-3460 and by electronic mail at douglas.jones@alaska.gov . The comments must be received not later than 5 p.m. on October 2, 2019.

You may submit written questions relevant to the proposed action to Mr. Doug Jones at douglas.jones@alaska.gov or 4501 Business Park Blvd., Ste. 24, Building L, Anchorage, AK 99503. The questions must be received at least 10 days before the end of the public comment period. The Department of Health & Social Services will aggregate its response to substantially similar questions and make the questions and responses available on the Alaska Online Public Notice System.

If you are a person with a disability who needs a special accommodation in order to participate in this process, please contact Mr. Doug Jones at (907) 269-0361 not later than September 16, 2019, to ensure that any necessary accommodations can be provided.

A copy of the proposed regulation changes is available on the Alaska Online Public Notice System and by contacting Mr. Doug Jones at douglas.jones@alaska.gov or 4501 Business Park Blvd., Ste. 24, Building L, Anchorage, AK 99503.

After the public comment period ends, the Department of Health & Social Services will either adopt the proposed regulation changes or other provisions dealing with the same subject, without further notice, or decide to take no action. The language of the final regulation may be different from that of the proposed regulation. You should comment during the time allowed if your interests could be affected. Written comments received are public records and are subject to public inspection.

Statutory authority: AS 47.05.010; AS 47.05.200; AS 47.05.235; AS 47.07.030; AS 47.07.040; AS 47.07.074.

Statutes being implemented, interpreted, or made specific: AS 47.05.010; AS 47.05.200; AS 47.05.235; AS 47.07.030; AS 47.07.040; AS 47.07.074.

Fiscal information: The proposed regulation changes are not expected to require an increased appropriation.

The Department of Health & Social Services/Medicaid Program Integrity keeps a list of individuals and organizations interested in its regulations. Those on the list will automatically be sent a copy of all of the Department of Health & Social Services/Medicaid Program Integrity notices of proposed regulation changes. To be added to or removed from the list, send a request to the Department of Health & Social Services/Medicaid Program Integrity at douglas.jones@alaska.gov , giving your name, and either your e-mail address or mailing address, as you prefer for receiving notices.

DATE: August 14, 2019.
/s/Adam Crum
Commissioner,
Department of Health & Social Services