Section 7 AAC 125.012 - Initial application for personal care services; reauthorization for personal care services(a) A recipient may apply for personal care services under 7 AAC 125.010 - 7 AAC 125.199 if that individual (1) is a current Medicaid recipient;(2) completes an application in a format provided by the department, with the assistance of (A) a provider of personal care services that is certified and enrolled under 7 AAC 125.060; or(3) reviews with the provider or department and completes by signing a rights and responsibilities form provided by the department; the provider shall or department will retain the form in the recipient's file, and provide a copy to the recipient; and(4) submits to the department a complete application that includes (A) a release of information, on a form provided by the department;(B) current information that is not older than one year before the date of the application and is in the form of (i) verification of the recipient's physical condition specified in 7 AAC 125.010(b)(1)(A); the verification must be submitted in a format provided by the department and must be completed by a licensed physician, physician assistant, or advanced practice registered nurse that is qualified to practice under AS 08 or 7 AAC 105.200(c); and(ii) records maintained under 7 AAC 105.230(d) that support the recipient's diagnosis and need for physical assistance with ADLs, IADLs, or other services identified in 7 AAC 125.030; and(C) if the recipient has a representative that will manage the recipient's personal care services, a document that identifies the recipient's representative and that representative's authority and responsibility.(b) A recipient that wishes to have personal care services reauthorized must submit to the department, not later than 60 days before the expiration of the recipient's current service level authorization, a complete application and the items required under (a) of this section,(c) A recipient determined not to qualify for personal care services on the basis of the recipient's application or after an assessment, may reapply in the same 365-day period only if a material change in the recipient's physical condition occurred after that determination. In this subsection, "material change" means an alteration in the physical condition of sufficient significance that the department is likely to reach a different decision regarding the recipient's need for physical assistance with ADLs, IADLs, and other covered activities.(d) Except as provided in 7 AAC 125.020, the department may reauthorize personal care services without a reassessment under 7 AAC 125.020, if the recipient documents in the application submitted in accordance with this section that the recipient (1) has a chronic or permanent physical condition that is stable and predictable; and(2) has experienced no changes that would affect the recipient's current service level authorization. Eff. 1/26/2012, Register 201; am 7/22/2017,Register 223, October 2017Authority:AS 47.05.010
AS 47.07.030