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Title 7 . Health and Social Services
Chapter 43 . Hearings
Section 1905.

7 AAC 43.1905. Noncovered items and services.

(a) Except as provided otherwise in this section, the department will not pay separately for durable medical equipment while the recipient is

(1) in a hospital, skilled nursing facility, or intermediate care facility; or

(2) receiving hospice care services.

(b) The department will not pay separately for home infusion therapy services

(1) while the recipient is in a hospital, skilled nursing facility, or an intermediate care facility;

(2) if the services are provided by or under arrangements made by a home health agency; or

(3) while the recipient is receiving hospice care services and the services are

(A) related to the treatment of the terminal illness that qualifies the recipient for hospice care; or

(B) provided by or under the arrangements made by the hospice program.

(c) The department will not pay for medical supplies or respiratory therapy assessment visits furnished to a recipient who is receiving hospice care services if the supplies or assessment visits are

(1) related to the treatment of the terminal illness that qualifies the recipient for hospice care; or

(2) provided by or under arrangements made by the hospice program.

(d) The department will not pay for specialized medical equipment, as defined in 7 AAC 43.1055, under 7 AAC 43.1900 - 7 AAC 43.1980.

(e) The department will not pay for the repair of durable medical equipment while the recipient is in a skilled nursing facility or intermediate care facility.

(f) The department will not pay separately for the repair, return shipping, or preventive maintenance or service of durable medical equipment, prosthetics, or orthotics for which the cost of repair, return shipping, or preventive maintenance or service is included in the rental fee.

History: Eff. 1/11/2006, Register 177

Authority: AS 47.05.010

AS 47.05.015

AS 47.07.030

AS 47.07.040


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Last modified 7/05/2006