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(3) be enrolled as a ground, water, or air ambulance Medicaid provider for the service period specified in the claim; and

(4) include only claims for dates of service on or after the provider’s Medicaid enrollment date, if a provider meets all other qualifications for the SEMT program and enrolls as a ground, water, or air ambulance Medicaid provider in the middle of the provider’s fiscal year; the department will not make payment for claims for services provided before the provider’s Medicaid enrollment date. (b) Not later than the last day of the fifth month after the close of the provider’s fiscal year, the SEMT provider must provide the documentation required under (c) of this section. The department may grant an extension of not more than 30 days, for good cause shown, if the SEMT provider requests the extension in writing. The department may grant an extension equal to the length of time determined by the Centers for Medicare and Medicaid Services (CMS), if CMS grants an extension for Medicare cost reports related to an issue that affects providers in this state. (c) The SEMT provider must

(1) renew SEMT participation annually by submitting a Supplemental Emergency Medical Transportation (SEMT) Provider Participation Agreement, adopted by reference in 7 AAC 160.900;

(2) complete and submit the Supplemental Emergency Medical Transportation (SEMT) Cost Report, adopted by reference in 7 AAC 160.900, in accordance with the Supplemental Emergency Medical Transportation (SEMT) Cost Report Instructions, adopted by reference in 7 AAC 160.900, and with CMS Publication 15-1: Principles of Reimbursement for Provider Costs;

(3) provide supporting documentation for the cost report and the cost determination prepared under AS 47.07.040 (state plan for provision of medical assistance), including

(A) audited financial statements, completed in accordance with generally accepted auditing standards (GAAS) or generally accepted government auditing standards (GAGAS), related to the cost report, or a separate schedule related to the cost report;

(B) a post-audit working trial balance for the audited financial statements;

(C) a reconciliation of the post-audit working trial balance to the cost report; and

(D) supporting documentation requested by the department;

(4) comply the allowable cost requirements provided in 2 C.F.R. Part 200, 42 C.F.R. Part 413, and Medicaid non-institutional reimbursement policy; and

(5) annually certify and allocate the provider’s direct and indirect costs as qualifying expenditures eligible for federal financial participation (FFP).