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Authority: AS 47.05.010 AS 47.07.030 AS 47.07.040 7 AAC 110.530. Private-duty nursing services; prior authorization. (a) Private-duty nursing services must be authorized by the department before services are provided. The department will authorize private-duty nursing services for periods up to 60 days, starting on the date the first service is to be provided. (b) To be considered by the department, a prior authorization request must originate from a private-duty nursing agency provider who submits the request in writing or electronically on a form provided by the department. The prior authorization request must

(1) include the plan of care developed in accordance with 7 AAC 110.525(b)(2) and signed by the recipient’s attending physician;

(2) include a nursing assessment;

(3) include any supporting documentation, if applicable;

(4) identify the day of actual or planned hospital or nursing facility discharge, if applicable;

(5) identify any planned surgical interventions;

(6) identify the number of days services are needed, not to exceed a 60-day period; and

(7) identify the exact number of hours requested per day. (c) To request additional hours within a 60-day period under (a) of this section, the private-duty nursing agency must submit, before the expiration of the current 60-day period, a new request for prior authorization. The new request must include

(1) daily nursing notes;

(2) an updated plan of care signed by the recipient’s attending physician;

(3) the attending physician’s order for service dated no sooner than seven days before the date of the request under this subsection;

(4) recent significant clinical findings from the recipient’s attending physician; and

(5) recent clinic summaries. (d) The department will approve a request for additional hours under (c) of this section, if

(1) the department finds that the individual who has agreed, in accordance with 7 AAC