Title 7 . Health and Social Services

Chapter 43 . Hearings

Section 1048. Intensive active treatment services

7 AAC 43.1048. Intensive active treatment services

(a) The department will reimburse for intensive active treatment services

(1) that are provided to a recipient in one of the following recipient categories:

(A) children with complex medical conditions;

(B) adults with physical disabilities; however, the department will reimburse only if a recipient in that recipient category is also diagnosed as experiencing a developmental disability;

(C) individuals with mental retardation or developmental disabilities;

(2) that are approved under 7 AAC 43.1030 as part of the recipient's plan of care;

(3) that receive prior authorization; and

(4) for which the professional providing or supervising the services submits supporting documentation to the department that the recipient needs immediate intervention to decelerate a condition or behavior regression that, if left untreated, would place the recipient at risk of institutionalization.

(b) The department will consider services to be intensive active treatment services if

(1) the department determines them to provide specific treatment or therapy, in the form of time-limited interventions to address a family problem or a personal, social, behavioral, mental, or substance abuse disorder in order to maintain or improve effective functioning of the recipient;

(2) each intervention requires the precision and knowledge possessed only by specifically trained professionals in specific disciplines, whose services are not covered under Medicaid or as habilitation services under 7 AAC 43.1045 - 7 AAC 43.1046; and

(3) the treatment or therapy is designed and provided by a professional licensed under AS 08 with expertise specific to the diagnosed condition, or by a paraprofessional licensed under AS 08 if necessary and supervised by that professional.

History: Eff. 5/15/2004, Register 170

Authority: AS 47.05.010

AS 47.07.030