Section 7 AAC 125.310 - Home health care services(a) The department will pay a public or private home health agency for the following home health care services, if recommended by a licensed physician, advanced practice registered nurse, or physician assistant as part of a plan of care developed in accordance with 7 AAC 125.320:(1) the following services if they are provided to a recipient in the recipient's place of residence by a public or private organization that the department has certified as a home health agency for purposes of Medicare: (A) intermittent or part-time skilled nursing services that are provided by a registered nurse or a licensed practical nurse, under the continued direction of the recipient's physician, advanced practice registered nurse, or physician assistant, and within the scope of the nurse's license;(B) home health aide services that are prescribed by and under the continued direction of a physician, advanced practice registered nurse, or physician assistant and supervised by a registered nurse;(C) supplies suitable for use in the home;(D) physical therapy, occupational therapy, speech-language pathology services, and audiology services that are prescribed by a physician, advanced practice registered nurse, or physician assistant and provided to a recipient by or under the supervision of a qualified practitioner;(2) skilled nursing services, at a payment rate determined under 7 AAC 145.700 - 7 AAC 145.730, if (A) they are provided by a rural health clinic enrolled under 7 AAC 140.200;(B) they are provided to a recipient by a registered nurse who receives written orders from the recipient's physician, advanced practice registered nurse, or physician assistant, and those services are within the scope of the nurse's license; and(C) the location of the recipient's place of residence is not served by any public or private organization that the department has certified as a home health agency for purposes of Medicare.(b) For purposes of this section, a place of residence (1) includes an assisted living home licensed under AS 47.32; and(2) does not include a hospital, skilled nursing facility, or intermediate care facility.(c) The department will not set a period longer than 60 days for prior authorization for payment of home health care services.(d) The department will pay a home health agency for home health care services provided to a recipient who is ehgible for Medicare, if on the basis of one or more of the following exclusions. Medicare will not pay for some or all of the home health care services ordered by the physician, advanced practice registered nurse, or physician assistant: (1) the recipient does not need intermittent or part-time skilled nursing services;(2) the recipient is not confined to the home.Eff. 2/1/2010, Register 193; am 5/1/2019, Register 230, April 2019; am 5/14/2021, Register 238, July 2021 Authority:AS 47.05.010
AS 47.07.030
AS 47.07.040