Alaska Administrative Code
Title 7 - Health and Social Services
Part 8 - Medicaid Coverage and Payment
Chapter 130 - Medicaid Coverage; Home and Community-Based Waiver Services
Article 2 - Home and Community-Based Waiver Services; Nursing Facility and ICF/MR Level of Care
7 AAC 130.275 - Intensive active treatment services
Universal Citation: 7 AK Admin Code 130.275
Current through November 28, 2024
(a) The department will pay for intensive active treatment services
(1) that are provided to a recipient in one
of the following recipient categories:
(A)
adults with physical and developmental disabilities;
(B) individuals with intellectual and
developmental disabilities 21 years of age and older;
(2) that are approved under
7
AAC 130.217 and
7
AAC 130.218 as part of the recipient's support
plan;
(3) that receive prior
authorization; and
(4) that are
approved under
7
AAC 130.217 and
7
AAC 130.218 as part of the recipient's plan of care;
(A) assesses the recipient's need for
services for a problem or disorder specified in (b)(2) of this
section;
(B) develops a written
plan for time-limited treatment or therapy that addresses that problem or
disorder, including an estimated number of units of service, if any, reserved
for distance delivery; distance delivery may not be more than 10 percent of the
total authorized units of service; and
(C) in addition to the written plan, submits
documentation to the department indicating that the recipient needs immediate
intervention for that problem or disorder, and that the problem or disorder, if
left untreated, would place the recipient at risk of
institutionalization.
(b) The department will consider a service to be an intensive active treatment services if the service
(1) provides specific treatment or therapy
that will maintain or improve the ability of the recipient to function
effectively;
(2) is in the form of
time-limited interventions that address
(A)
the recipient's personal, social, behavioral, or mental problem;
(B) the recipient's substance use disorder;
or
(C) a family problem related to
the recipient's problem or disorder;
(3) requires the knowledge possessed only by
professionals specially trained in specific disciplines, and the services of
those professionals are not otherwise covered as Medicaid services, as day
habilitation services under
7
AAC 130.260, or as residential habilitation services
under 7 AAC 130.265; and
(4) provides treatment or therapy that is
planned and rendered by
(A) an individual
certified under title
AS
14.20.010 with a special education
endorsement obtained under
4
AAC 12.330; or
(B) a professional licensed under AS 08 with
expertise specific to the diagnosed problem or disorder, or by a
paraprofessional supervised by that professional and licensed under AS 08 if
required.
(c) The department will not pay for intensive active treatment services that
(1) are intended as therapy or treatment for
problems or disorders specified in (b)(2) of this section that are ongoing
rather than time-limited problems or disorders, or that do not place the
recipient at risk of institutionalization; or
(2) involve training, oversight, or
monitoring of
(A) a caregiver; or
(B) another individual who provides the
recipient a health-related service.
Authority:AS 47.05.010
AS 47.07.030
AS 47.07.040
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