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medical transportation costs that have not been paid by any other source by Medicaid fund type;
(4) the calculated Medicaid emergency medical transportation costs not paid by any other source for each Medicaid fund type described in 7 AAC 145.750(d) will be multiplied by the federal medical assistance percentage (FMAP) within the meaning given in 42 U.S.C. 1396d(b) for that Medicaid fund type, including claims for non-Indian Health Service providers that have been tribally refinanced in accordance with CMS State Health Official (SHO) letter #16-002, Re: Federal Funding for Services “Received Through” an IHS/Tribal Facility and Furnished to Medicaid-Eligible American Indians and Alaska Natives (February 26, 2016), to determine the final settlement. (e) Based on the process set out in (a) - (d) of this section, the department will
(1) recover from the participating provider the federal payments that exceed the participating provider’s cost per qualifying transport, after adjustments for other sources of reimbursement as described in (d) of this section; or
(2) pay the participating provider a federal funds supplemental payment if the process described in (d) of this section results in additional Medicaid emergency medical transportation costs that have not been covered by any other source of reimbursement. (f) The department will report to the Centers for Medicare and Medicaid Services (CMS) any difference between the payment of federal funds made to the participating providers and the federal share of the qualifying expenditures and return the excess funds to CMS. (g) The department will conduct the cost settlement process within three years of receipt of the as-filed annual report in 7 AAC 145.760. (Eff. 10/9/2021, Register 240) Statutory Authority: Authority: AS 47.05.010 AS 47.07.040 AS 47.07.085 7 AAC 145.790. SEMT administrative fee. (a) The provider must pay the department an administrative fee to cover the cost of the SEMT program. (b) The fee is equal to the state general fund cost to the department to administer the SEMT program. The department will use the fee to pay the required state match for federal funding. (c) The fee is a flat fee per Medicaid emergency medical transports for the service period in