Section 7 AAC 110.705 - Vision care services(a) The department will pay for only the vision services and products identified in the Fee Schedule for Vision Services, adopted by reference in 7 AAC 160.900, subject to the provisions of this section.(b) The department will pay for the following services in each calendar year for a recipient under 21 years of age: (1) one vision examination if the vision examination meets the requirements of 7 AAC 110.710;(2) any vision examination, in addition to the examination in (1) of this subsection, if the department gives prior authorization based upon medical justification submitted by the provider;(3) one complete pair of eyeglasses, or a one-year supply of contact lenses, that meets the requirements of (d) of this section;(4) one additional complete pair of eyeglasses, or additional supply of contact lenses prorated for the remainder of the year, that meets the requirements of (d) of this section, if the (A) first pair of eyeglasses or supply of contact lenses is lost or broken; or(B) prescription changes;(5) any subsequent complete pair of eyeglasses, or subsequent supply of contact lenses prorated for the remainder of the year, that meets the requirements of (d) of this section, if the department gives prior authorization based upon medical justification submitted by the provider;(6) one fitting for each pair of glasses covered under this subsection.(c) The department will pay for the following services for a recipient 21 years of age or older: (1) in each calendar year period (A) one vision examination, if the vision examination meets the requirements of 7 AAC 110.710;(B) any vision examination, in addition to the examination in (A) of this paragraph, if the vision examination meets the requirements of 7 AAC 110.710 and if the department gives prior authorization based on medical justification submitted by the provider;(2) in each two-year calendar year period (A) one complete pair of eyeglasses, or two one-year supplies of contact lenses that meet the requirements of (d) of this section;(B) one additional complete pair of glasses, or additional supply of contact lenses prorated for the remainder of the two-year period, that meets the requirements of (d) of this section, if the department gives prior authorization based on medical justification submitted by the provider;(C) one fitting for each pair of glasses covered under this paragraph.(d) The department will pay for contact lenses and contact lens fittings that meet the requirements of this section if (1) the claim is accompanied by written medical justification; and(2) contacts are medically necessary as a result of (D) corneal degeneration;(E) rejection of an implant; or(F) ocular surface disease or abrasion requiring temporary bandaging contact lens.(e) In addition to authorization requirements identified in this section, the following vision products and services require prior authorization by the department, based upon medical justification submitted by the provider:Eff. 2/1/2010, Register 193; am 3/1/2013, Register 205; am 3/22/2014, Register 209, April 2014; am 3/3/2023, Register 245, April 2023Authority:AS 47.05.010
AS 47.07.030
AS 47.07.040