7 AAC 43.484. Prior authorization of mental health rehabilitation services

A provider request for prior authorization of an extension of a service beyond service limitations, or a provider request for a change in the level of the service that a recipient previously received, must be made in writing on the form approved by the division, and must be received by the division 15 days before the end of the current approved period of service. The request must

(1) be documented in the clinical record prepared under 7 AAC 43.728;

(2) include a listing of all Medicaid reimbursable services and the expected duration of these services as set out in the recipient's individualized treatment plan; and

(3) affirm that the recipient's interdisciplinary team in accordance with 7 AAC 43.470, if the recipient is a severely emotionally disturbed child, or the recipient's physician or mental health professional clinician, if the recipient is a severely emotionally disturbed adult or a chronically mentally ill adult, has reviewed the treatment plan and recommended the requested services as medically necessary.

History: Eff. 11/1/2000, Register 156

Authority: AS 47.05.010

AS 47.07.030

AS 47.07.040

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