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7 AAC 145.290. Long-term services and supports targeted case management. (a) For long-term services and supports targeted case management services provided under 7 AAC 128.010, the department will pay a unit of service at the lesser of the

(1) amount charged by the provider to the public; or

(2) the payment rate established in the department’s Chart of Long Term Services and Supports Targeted Case Management Services Rates, adopted by reference in 7 AAC 160.900. (b) The payment rates in the Chart of Long Term Services and Supports Targeted Case Management Services Rates will be reestablished at least every four years using a modeled rate methodology as noted in the department’s Rate-Setting Methodology for Personal Care Services, Community First Choice Services, Long-Term Services and Supports Targeted Case Management Services, and Waiver Services, adopted by reference in 7 AAC 160.990, that includes components for salaries, fringe benefits, administrative/general, and case load size. (c) Each July 1 that the payment rates in the Chart of Long Term Services and Supports Targeted Case Management Services Rates are not re-established under (b) of this section, the department will adjust the payment rate for inflation using the CMS Home Health Agency Market Basket in the most recent quarterly publication of Global Insight’s Healthcare Cost Review available 60 days before July 1. (d) Each July 1 that the payment rates listed in the Chart of Personal Care Services and Community First Choice Services Rates are re-established under (b) of this section or adjusted under (c) of this section, the department will further adjust the payment rates to reflect regional differences in the cost of doing business based on the designated planning regions described in Table I-1 of the Alaska Geographic Differential Study 2008, dated April 30, 2009, and adopted by reference in 7 AAC 160.900, with a factor of 1.00 being the lowest factor applied and with the four southeast regional factors being averaged to a single weighted applicable factor of 1.09. (Eff. 10/1/2018, Register 227; am 7/1/2019, Register 231; am 5/1/2023, Register 246) Statutory Authority: Authority: AS 47.05.010 AS 47.07.030 AS 47.07.040 Article 4. Payment Rates; Therapies and Related Services. Rule 7 AAC 145.300. Occupational therapy services payment rates