7 Alaska Admin. Code § 130.275

Current through May 31, 2024
Section 7 AAC 130.275 - Intensive active treatment services
(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.

7 AAC 130.275

Eff. 2/1/2010, Register 193; am 3/1/2011, Register 197; am 7/1/2013, Register 206; am 7/1/2015, Register 214, July 2015; am 11/5/2017, Register 224, January 2018; am 7/1/2018, Register 226, July 2018; am 3/3/2021, Register 238, July 2021; am 9/18/2022, Register 243, October 2022

Authority:AS 47.05.010

AS 47.07.030

AS 47.07.040