Page 2497

Official source

Editor’s note: As of Register 236 (January 2021), and acting under AS 44.62.125(b)(6), the regulations attorney corrected a manifest error in 7 AAC 125.010(b)(1)(A)(i). 7 AAC 125.012. Initial application for personal care services; reauthorization for personal care services. (a) A recipient may apply for personal care services under 7 AAC 125.010 — 7 AAC 125.199 if that individual

(1) is a current Medicaid recipient; and

(2) completes an application in a format provided by the department, with the assistance of

(A) a provider of personal care services that is certified and enrolled under 7 AAC 125.060; or

(B) the department;

(3) reviews with the provider or department and completes by signing a rights and responsibilities form provided by the department; the provider shall or department will retain the form in the recipient’s file, and provide a copy to the recipient; and

(4) submits to the department a complete application that includes

(A) a release of information, on a form provided by the department;

(B) current information that is not older than one year before the date of the application and is in the form of

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Page 2497

Official source

Editor’s note: As of Register 236 (January 2021), and acting under AS 44.62.125(b)(6), the regulations attorney corrected a manifest error in 7 AAC 125.010(b)(1)(A)(i). 7 AAC 125.012. Initial application for personal care services; reauthorization for personal care services. (a) A recipient may apply for personal care services under 7 AAC 125.010 — 7 AAC 125.199 if that individual

(1) is a current Medicaid recipient; and

(2) completes an application in a format provided by the department, with the assistance of

(A) a provider of personal care services that is certified and enrolled under 7 AAC 125.060; or

(B) the department;

(3) reviews with the provider or department and completes by signing a rights and responsibilities form provided by the department; the provider shall or department will retain the form in the recipient’s file, and provide a copy to the recipient; and

(4) submits to the department a complete application that includes

(A) a release of information, on a form provided by the department;

(B) current information that is not older than one year before the date of the application and is in the form of

(i)verification of the recipient’s physical condition…#

(i) verification of the recipient’s physical condition specified in 7 AAC 125.010(b)(1)(A); the verification must be submitted in a format provided by the department and must be completed by a licensed physician, physician assistant, or advanced practice registered nurse that is qualified to practice under AS 08 or 7 AAC 105.200(c); and

(ii)records maintained under 7 AAC 105.230(d) that support…#

(ii) records maintained under 7 AAC 105.230(d) that support the recipient’s diagnosis and need for physical assistance with ADLs, IADLs, or other services identified in 7 AAC 125.030; and

(C) if the recipient has a representative that will manage the recipient’s personal care services, a document that identifies the recipient’s representative and that representative’s authority and responsibility. (b) A recipient that wishes to have personal care services reauthorized must submit to the department, not later than 60 days before the expiration of the recipient’s current service level