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(7) home infusion therapy;

(8) enteral and oral nutritional products;

(9) the purchase of durable medical equipment, medical supplies, prefabricated off-the-shelf orthotics, or related items and services under 7 AAC 120.200(a)(2) for a recipient in a skilled nursing facility or intermediate care facility;

(10) continuous oxygen for a recipient in a skilled nursing facility or an intermediate care facility;

(11) the purchase of durable medical equipment, medical supplies, prefabricated off-the-shelf orthotics, or related items and services under 7 AAC 120.200(a)(2) if the charge to the department exceeds $1,000;

(12) medical supplies and services for a single claim or for a 30-day supply if the charge to the department exceeds $1,000;

(13) durable medical equipment, medical supplies, prefabricated off-the-shelf orthotics, or related items and services under 7 AAC 120.200(a)(2) requiring CMS prior authorization under 42 C.F.R. 414.234(c)(1);

(14) Medicare-covered durable medical equipment, medical supplies, prefabricated off-the-shelf orthotics, or related items and services under 7 AAC 120.200(a)(2) that are for a recipient who is eligible under both Medicare and Medicaid, and that Medicare

(A) has determined medically unnecessary for that recipient; or

(B) has denied after finding that a provider sought payment in excess of copay and deductible;

(15) optimally configured power wheelchairs that require payment under capped rental rules provided where the provider of durable medical equipment, medical supplies, prefabricated off-the-shelf orthotics, or related items and services under 7 AAC 120.200(a)(2) requests direct purchase; and

(16) items that are medically necessary to be replaced before the qualified replacement time, even if they had not initially been identified as requiring service authorization. (c) A request for service authorization must be consistent with Medicare requirements where applicable and must also include

(1) a prescription order with a certificate of medical necessity completed by the enrolled ordering

(A) physician;

(B) physician assistant; or

(C) advanced practice registered nurse;