7 AAC 138.040 - Service rates, service limits, and service authorization

(a) Substance use disorder 1115 waiver services rates are established in the department's Chart of 1115 Waiver Services, adopted by reference in 7 AAC 160.900.

(b) The department will not pay for substance use disorder 1115 waiver services beyond the limits listed in the Alaska Behavioral Health Provider Service Standards & Administrative Procedures for SUD Provider Services, adopted by reference in 7 AAC 160.900, without prior authorization from the department.

(c) A provider of substance use disorder 1115 waiver services must file a request for prior authorization of an extension of an substance use disorder 1115 waiver service beyond service limitations using a form approved by the department. The request must

(1) be documented in the clinical record;

(2) include the expected duration of the service; and

(3) include an explanation for the need to extend the service.

(d) A provider that meets the requirements of 7 AAC 136.020 may provide any substance use disorder 1115 waiver service without prior authorization from the department.

(e) The department may review a provider's clinical record to confirm the need for an extension of substance use disorder 1115 wavier services.

Notes

7 AAC 138.040

Eff. 7/1/2019, Register 231, July 2019; am 11/10/2019, Register 232, January 2020; am 5/21/2020, Register 234; am 10/4/2020, Register 236

An emergency regulation for this section, filed on July 1, 2019, expired October 28, 2019. The regulation was made "permanent" by the adopting agency.

Authority:AS 47.05.010

AS 47.07.030