IDAPA 16.03.10.302 - Personal Care Services: Eligibility (prior authorization, assessment, plan of care, annual redetermination)

What this rule requires your agency to do

• 1Payment for PCS is prior authorized by the Bureau of Long Term Care only when the participant can be maintained safely in their own home using PCS, an adult UAI or children's PCS assessment has been completed, medical necessity is documented, and the participant has a plan of care meeting the person-centered planning requirements in Sections 316 and 317 (302.02).(IDAPA 16.03.10.302 - Personal Care Services: Eligibility (prior authorization, assessment, plan of care, annual redetermination))
• 2A participant's PCS eligibility must be redetermined at least annually under Subsections 302.01 through 302.03; the medical redetermination assesses continued need for PCS, discharge, and referral to a nursing facility (302.04).(IDAPA 16.03.10.302 - Personal Care Services: Eligibility (prior authorization, assessment, plan of care, annual redetermination))