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(B) the patient requires restraint; or
(C) ambulance service is necessary to meet the requirements of 42 U.S.C. 1395dd (Emergency Medical Treatment and Active Labor Act (EMTALA)) and 42 C.F.R. 489.24;
(4) the co-pay portion of a third-party reimbursement;
(5) any transportation or other expense to be paid by the court system for proceedings under AS 47.30; or
(6) any service that is not directly related to the patient’s mental condition that resulted in eligibility for financial assistance under AS 47.31.010. (e) For a patient admitted after an involuntary commitment under AS 47.30.700 — 47.30.815 or a voluntary commitment chosen after the patient’s physician determines that the patient meets the involuntary commitment criteria in AS 47.30.700 — 47.30.815, the treating physician shall
(1) using a form supplied by the department, certify upon admission that the patient meets the involuntary commitment criteria in AS 47.30.700 — 47.30.815; if the patient subsequently transfers to voluntary commitment, the treating physician shall certify daily, on the patient’s chart, whether the patient continues to meet the involuntary commitment criteria; and
(2) recertify every seven days, on the form supplied by the department, whether the patient continues to meet the involuntary commitment criteria. (f) The department may, on a case-by-case basis, deny reimbursement under 7 AAC 72.540 if the department determines that a service provided is not directly related to the patient’s mental health condition. (Eff. 3/16/2001, Register 157; am 6/24/2004, Register 170) Statutory Authority: Authority: AS 47.30.660 AS 47.31.025 AS 47.31.090 7 AAC 72.530. Application for financial assistance. (a) An application for assistance that is submitted under AS 47.31.015(a) must include
(1) a copy of the invoice for the services for which financial assistance is sought;
(2) proof of gross monthly household income; this proof includes paycheck stubs, tax records, unemployment check stubs, a signed statement from an employer, or any other