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 130.305 - Specialized medical equipment
Universal Citation: 7 AK Admin Code 130.305
Current through November 28, 2024
(a) The department will pay for specialized medical equipment that
(1) is supported by a prescription or other
written documentation required by the department's Specialized Medical
Equipment Fee Schedule, adopted by reference in
7
AAC 160.900,
(A)
from an individual with an active license under AS 08 to practice as
(i) a physician, including an
osteopath;
(ii) a physician
assistant;
(iii) an advanced
practice regsitered nurse;
(iv) an
occupational therapist; or
(v) a
physical therapist; and
(B) stating that the specific item requested
is appropriate for the recipient and consistent with the support
plan;
(2) is supported
by a written cost estimate;
(3) is
approved under
7
AAC 130.217 and
7
AAC 130.218 as part of the recipient's support plan;
and
(4) receives prior
authorization.
(b) The department will consider an item to be specialized medical equipment if that item is
(1) a device, control, or appliance
that increases the recipient's ability to perform activities of daily living
described in
7
AAC 125.030(b) or to perceive,
control, or communicate with the environment in which the recipient lives, or
is equipment necessary for the proper functioning of that item; and
(2) identified in the department's
Specialized Medical Equipment Fee Schedule, adopted by
reference in
7
AAC 160.900.
(c) The department will pay under this section subject to the following:
(1) the
unit cost of equipment is determined by including the cost of
(A) training in the equipment's proper use;
and
(B) routine fitting of and
maintenance on the equipment necessary to meet applicable standards of
manufacture, design, and installation;
(2) the department will not pay, as a home
and community-based waiver service, the cost of any medical equipment or
supplies payable under
7
AAC 120.200 -
7
AAC 120.399
(3) specialized medical equipment and
supplies shall be rented if the equipment is a personal emergency response
system or if the department determines that renting the equipment is more
cost-effective than purchasing it;
(4) once purchased, specialized medical
equipment become the property of the recipient;
(5) the department will not give prior
authorization to replace specialized medical equipment before the expiration of
the time period identified in the department's Specialized Medical
Equipment Fee Schedule, adopted by reference in
7
AAC 160.900, unless the department determines that
replacement is more cost-effective than repairing that equipment.
Authority:AS 47.05.010
AS 47.07.030
AS 47.07.040
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