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Authority: AS 47.05.010 AS 47.07.030 AS 47.07.040 7 AAC 140.315. Noncovered hospital services. (a) Except as otherwise provided in 7 AAC 105 — 7 AAC 160, the department will not pay for services

(1) identified as noncovered services in 7 AAC 105.110; or

(2) for which a revenue code is not listed as described in 7 AAC 140.310(a). (b) Except as otherwise provided in 7 AAC 105 — 7 AAC 160, the department will not pay a hospital for the following services and procedures:

(1) a service that is not within the scope of the facility’s licensure, certification, or accreditation;

(2) the following services, unless the department gives prior authorization specifically for the service:

(A) the dispensing of antabuse;

(B) methadone treatment, including the dispensing of methadone;

(C) alcohol or drug detoxification or rehabilitation;

(3) tobacco cessation therapy and services; however, the department will pay for tobacco cessation products;

(4) leaves of absence, including charges for holding a recipient’s room or bed, except as described under 7 AAC 140.585 when a recipient is in a hospital’s long-term care facility;

(5) services and procedures that do not require hospital care, including

(A) outpatient special residence charges, rest cures, daily respite care under 7 AAC 130.280, adult day services, or day care for children;

(B) room and board for individuals other than the patient, unless the department gives prior authorization specifically for the service;

(C) admission solely for the purpose of medical and dental services, surgical procedures, or diagnostic testing that can be performed on an outpatient basis or in an ambulatory surgical center; however, the department will give prior authorization specifically for a service, procedure, or test if the recipient’s