NOTICE OF PROPOSED CHANGES ON MEDICAID COVERAGE OF DURABLE MEDICAL EQUIPMENT IN THE REGULATIONS OF THE DEPARTMENT OF HEALTH AND SOCIAL SERVICES

The Department of Health and Social Services proposes to adopt regulation changes in Title 7, Chapters 120, 145, 160, of the Alaska Administrative Code, dealing with Medicaid coverage and payment for durable medical equipment, orthotics, prosthetics, and supplies, and adoption by reference of related material, including:

1.  7 AAC 120.200, Enrollment; general provisions; covered items and services, is proposed to be amended to revise the enrollment requirements, payment coverage, home infusion therapy, provider requirements, prior authorization, prescriptions, and medical necessity.

2.  7 AAC 120.205, Noncovered items and services, is proposed to be amended to update the list of items and services that will not be covered by the department relating to durable medical equipment.

3.  7 AAC 120.210, Prior authorization, is proposed to be amended to further define the prior authorization requirements relating to durable medical equipment.

4.  7 AAC 120.215, Purchase of items, is proposed to be amended to add new subsections dealing with rental of durable medical equipment and purchase of used equipment.

5.  7 AAC 120.220, Replacement of items, is proposed to be amended to clarify coverage and payment for replacement of items.

6.  7 AAC 120.225, Rental of items; general provisions, is proposed to be amended to revise the coverage and payment for rental of durable medical equipment.

7.  7 AAC 120.230, Rental of items; changes during rental periods, is proposed to be amended to further outline what the department will pay for when there is an interruption in a rental period.

8.  7 AAC 120.240, Enteral and oral nutritional products, is proposed to be amended to revise the coverage and payment requirements for enteral and oral nutritional products.

9.  7 AAC 120.299, Definitions, is proposed to be amended to further define terms used relating to the durable medical equipment, orthotics, prosthetics, and supplies.

10.  7 AAC 145.420, Durable medical equipment, supplies, and respiratory therapy payment rates, is proposed to be amended to revise the payment and coverage requirements for durable medical equipment, supplies, and respiratory therapy services.

11.  7 AAC 160.900, Requirements adopted by reference, is proposed to be amended to update some of the Medicaid fee schedules and repeal those that are no longer in use.

12.  7 AAC 160.990, Definitions, is proposed to be amended to define terms used in 7 AAC 120 – 145 relating to durable medical equipment.

You may comment on the proposed regulation changes, including the potential costs to private persons of complying with the proposed changes, by submitting written comments to Chad Hope, Division of Health Care Services, 4501 Business Park Blvd, Suite 24, Anchorage, AK  99503; E-mail: chad.hope@alaska.gov. The comments must be received no later than 4:00 p.m. on December 22, 2014.

You may submit written questions relevant to the proposed action to Chad Hope, Division of Health Care Services, 4501 Business Park Blvd, Suite 24, Anchorage, AK  99503; E-mail: chad.hope@alaska.gov. The questions must be received at least 10 days before the end of the public comment period. The Department of Health and Social Services will aggregate its response to substantially similar questions and make the questions and responses available http://dhss.alaska.gov/Pages/Regulations.aspx. The Department of Health and Social Services may, but is not required to, answer written questions received after the 10-day cut-off date and before the end of the comment period.

If you are a person with a disability who needs a special accommodation in order to participate in this process, please contact Chad Hope at the address above or by phone at (907) 334-2654 no later than December 22, 2014 to ensure that any necessary accommodations can be provided.

A copy of the proposed regulation changes and a copy of the material proposed for adoption by reference are available on the Alaska Online Public Notice System and by contacting Chad Hope at the address, phone number, or E-mail address above.

After the public comment period ends, the Department of Health and Social Services will either adopt the proposed regulation changes or other provisions dealing with the same subject, without further notice, or decide to take no action. The language of the final regulations may be different from that of the proposed regulations. You should comment during the time allowed if your interests could be affected.

Statutory Authority: AS 47.05.010, AS 47.05.015, AS 47.05.012, AS 47.07.030, AS 47.07.040, AS 47.07.055

Statutes Being Implemented, Interpreted, or Made Specific: AS 47.05.010, AS 47.05.015, AS 47.05.012, AS 47.07.030, AS 47.07.040, AS 47.07.055.

Fiscal Information: The proposed regulation changes are not expected to require an increased appropriation.

Date: November 5, 2014                                            

/s/
William J. Streur, Commissioner
Department of Health and Social Services