Arkansas Administrative Code
Agency 016 - DEPARTMENT OF HUMAN SERVICES
Division 06 - Medical Services
Rule 016.06.07-055 - Living Choices Assisted Living Provider Manual Update Transmittal #41
Universal Citation: AR Admin Rules 016.06.07-055
Current through Register Vol. 49, No. 9, September, 2024
212.000 Living Choices Assisted Living Services
Medicaid covers Living Choices services on a daily, all-inclusive basis, rather than on an itemized per-service basis. A day is a covered date of service when a participant receives any of the services described in Sections 212.100 through 212.500 between midnight on a given day and midnight of the following day. A day is not a covered date of service when a participant does not receive any Living Choices services between midnight of that day and midnight of the following day.
A. Basic Living Choices Assisted Living
direct care services are:
1. Attendant care
services,
2. Therapeutic social and
recreational activities,
3.
Periodic nursing evaluations,
4.
Limited nursing services,
5.
Assistance with medication to the extent that such assistance is in accordance
with the Arkansas Nurse Practice Act and interpretations thereto by the
Arkansas Board of Nursing,
6.
Medication oversight to the extent permitted under Arkansas law and
7. Assistance obtaining non-medical
transportation specified in the plan of care.
B. Living Choices participants are eligible
for pharmacist consultant services. Level II ALFs are required by their
licensing regulations to engage a Consultant Pharmacist in Charge. Consultant
Pharmacists in Charge may enroll in the Living Choices Program to provide
individualized pharmacy consultant services in accordance with Living Choices
participants' plans of care.
C.
Living Choices waiver participants are eligible for the regular benefit of
three prescription drugs per month, plus three additional prescription drugs by
prior authorization, and up to three more prescriptions per month, for a total
of nine prescriptions per month. Living Choices waiver participants who are
dual eligibles (receiving both Medicare and Medicaid) must obtain prescribed
medications through the Medicare Part D Prescription Drug Plan, or for certain
prescribed medications excluded from the Medicare Part D Prescription Drug
Plan, through the Arkansas Medicaid State Plan Pharmacy Program.
214.000 Benefit Limits
A. There are no benefit limits
applicable to the Living Choices Assisted Living bundled services and
pharmacist consultant benefits.
B.
Living Choices Assisted Living Program participants are eligible for three
prescription drugs per month in addition to the regular Medicaid pharmacy
benefit. The regular Medicaid pharmacy benefit is three prescription drugs per
month, plus three additional prescription drugs available by prior
authorization, for a total of six. Living Choices participants may have as many
as nine prescription drugs per month covered by Medicaid. Dual eligibles,
receiving both Medicare and Medicaid, receive prescription drug coverage
through Part D Medicare and have no restrictions on the number of prescription
drugs that can be received during a month.
Disclaimer: These regulations may not be the most recent version. Arkansas may have more current or accurate information. We make no warranties or guarantees about the accuracy, completeness, or adequacy of the information contained on this site or the information linked to on the state site. Please check official sources.
This site is protected by reCAPTCHA and the Google
Privacy Policy and
Terms of Service apply.
