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(a) The department will only provide Medicaid reimbursement for personal care services that are performed in accordance with 7 AAC 43.750 - 7 AAC 43.795 and applicable federal and state laws.
(b) The department will base its reimbursement on the tasks specified in the recipient's approved PCAT service plan under 7 AAC 43.751 and the time authorized by the PCAT service plan for each task, to the extent that the task and times are consistent with the recipient's condition.
(c) In the agency-based and consumer-based programs, the total time per task for each week may not exceed the time authorized in the recipient's PCAT service plan. If the time-per-task activity is provided less than one time per week, the time may not exceed the authorized time per period.
(d) Reimbursement for an enrolled personal care agency's provision of personal care services may not exceed $21 an hour. This rate includes reimbursement for all personal care and administrative services rendered, including travel and telephone expenses. At least 50 percent of the annual total reimbursement paid by the department to a personal care agency for personal care services must be spent on compensation for personal care assistants.
(e) On or after February 1, 2007, a personal care assistant's rendering provider identification number must be submitted with each claim that the personal care agency submits for Medicaid reimbursement from the department.
History: Eff. 11/6/86, Register 100; am 6/27/92, Register 122; am 7/1/95, Register 134; readopt 8/7/96, Register 139; am 3/1/98, Register 145; am 10/21/98, Register 148; am 10/1/2001, Register 159; am 1/1/2002, Register 160; am 6/19/2004, Register 170; am 4/1/2006, Register 177
Authority: AS 47.05.010
Editor's note: Effective 8/7/96, Register 139, the Department of Health and Social Services readopted 7 AAC 43.790 in its entirety, without change, under AS 47.05 and AS 47.07. Executive Order No. 72 transferred certain rate-setting authority to the department.
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Last modified 7/05/2006