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(A) reasonably calculated to diagnose, correct, cure, alleviate, or prevent the worsening of medical conditions that endanger life, cause suffering or pain, result in illness or infirmity, threaten to cause or aggravate a disability, or cause physical deformity or malfunction; and

(B) used because an equally effective more conservative or substantially less costly course of medical diagnosis or treatment is not available or suitable for the Medicaid recipient requesting the service; for purposes of this subparagraph, “course of treatment” includes mere observation or, if appropriate, no treatment at all. (l) This section does not apply to a federally qualified health center that elects to be reimbursed under 7 AAC 155.010(1). (Eff. 2/1/2010, Register 193; am 10/1/2017, Register 223; am 4/24/2020, Register 234; am 11/1/2021, Register 240) Statutory Authority: Authority: AS 47.05.010 AS 47.07.040 AS 47.07.073

AS 47.07.030 AS 47.07.070 Editor’s note: As of Register 197 (April 2011) the regulations attorney made a technical revision under AS 44.62.125(b)(6), to 7 AAC 145.700(c). 7 AAC 145.710. Calculating total health clinic visits. For newly rebased rates on or after February 16, 2024, for the purposes of calculating a rate under 7 AAC 145.700(c) for a rural health clinic, or a federally qualified health center, the department will consider the total number of visits to be the sum of the total visits from Worksheet B Parts I & II of the adjusted Medicare cost report, and if applicable, dental visits. (Eff. 2/1/2010, Register 193; am 4/24/2020, Register 234; am 11/1/2021, Register 240; am 4/16/2023, Register 246; am 2/16/2024, Register 249) Statutory Authority: Authority: AS 47.05.010 AS 47.07.040 AS 47.07.073