Page 2888

(b) For care coordination services provided under 7 AAC 130.240,

(1) the department will pay a unit of service at the lesser of the

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

(B) rates established in the department’s Chart of Waiver Services Rates, adopted by reference in 7 AAC 160.900;

(2) the payment rates listed in the Chart of Waiver Services Rates for care coordination services provided under 7 AAC 130.240(b)(1) and (2) will be re-established 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 160.900, that includes components for salaries, fringe benefits, administrative/general, and caseload size; and

(3) each July 1 that the payment rates for care coordination services in the Chart of Waiver Services Rates are not re-established under (2) of this subsection, the rates will be adjusted as provided in 7 AAC 145.525(b). (c) For specialized medical equipment and supplies provided under 7 AAC 130.305, the department will pay at the lesser of the

(1) amount charged by the provider in accordance with 7 AAC 145.020; or

(2) maximum allowable amount specified for that item in the Specialized Medical Equipment Fee Schedule, adopted by reference in 7 AAC 160.900. (d) For specialized private duty nursing services provided under 7 AAC 130.285, the department will pay a unit of service at the lesser of the

(1) amount charged by the provider in accordance with 7 AAC 145.020; or

(2) rate described in 7 AAC 145.250. (e) For environmental modification services provided under 7 AAC 130.300, the department will pay at 100 percent of billed charges to a home and community-based waiver services provider that oversees the purchase and installation of an environmental modification for a recipient. In addition, the department will pay the provider an administrative fee of two percent of the billed charges or $100, whichever is greater, if the provider is

(1) certified under 7 AAC 130.220(a)(1)(K); and

(2) an organized health care delivery system under 42 C.F.R. Part 447. (f) For adult day services provided under 7 AAC 130.250, residential supported-living services provided under 7 AAC 130.255, day habilitation services provided under 7 AAC 130.260, residential habilitation services provided under 7 AAC 130.265, employment services