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7 AAC 120.305. Noncovered items and services. (a) The department will not pay separately for the repair, return shipping, or preventive maintenance or service of prosthetics or orthotics for which the cost of repair, return shipping, or preventive maintenance or service is included in the rental fee or warranty. (b) The department will not pay for the repair or preventive maintenance or service of prosthetics or orthotics for which there is no documented medical necessity that is current under 7 AAC 120.200( l) for the continued use of that item. (c) The department will not pay a provider enrolled as a prosthetics and orthotics provider under 7 AAC 120.300 for medical supplies that are required under federal law to be provided at no cost to employees, including gloves, masks, and isolation gowns. (d) The department will not pay for services rendered during any period in which the provider is out of compliance with provider enrollment requirements under 7 AAC 120.300. (Eff. 6/2/2019, Register 230) Statutory Authority: Authority: AS 47.05.010 AS 47.07.030 AS 47.07.040 7 AAC 120.310. Service authorization; prosthetic or orthotic items or services. (a) A provider seeking service authorization must make a request electronically or in writing on a certificate of medical necessity. (b) Service authorization is required for

(1) items or services indicated as requiring service authorization on the Alaska Medicaid DMEPOS Fee Schedules, Tables I-5 through I-9, adopted by reference in 7 AAC 160.900, including prosthetic or orthotic items or services;

(2) medical supplies that exceed the maximum units or a 30-day limit set by the department;

(3) items that are identified as miscellaneous in the United States Department of Health and Human Services, Centers for Medicare and Medicaid Services’ (CMS) Healthcare