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PAS reassessments must be completed on some ALTCS members to determine continued medical eligibility. The criteria for continued qualification for ALTCS services are the same as for the initial PAS.
EPD Members who were made eligible by physician consultant review on their last assessment and are under age 65 require an annual assessment.
A reassessment may be completed at any time for the following reasons:
A routine audit of the PAS assessment reveals a question regarding the eligibility determination;
A review by Administration or an ALTCS physician consultant determines the member may not have a continuing need for long term care services; or
A Program Contractor, case manager, nursing facility, or other party requests a review that reveals a question regarding continuing eligibility.
NOTE A reassessment may be scheduled at six months when it appears that a customer may not have a continued need for long term care services in the judgment of the physician consultant or PAS Assessor, in consultation with his or her supervisor.
For more information on PAS Reassessments, see MAP1007 PAS Reassessments.
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Term |
Definition |
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Reassessment |
Means the process of redetermining PAS eligibility for ALTCS services. |
Proof of immediate risk of institutionalization shall be demonstrated through:
Applicant or member score equal to or higher than the applicable PAS threshold score; or
Finding by a physician consultant reviewer that the applicant or member has this status.
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Program |
Legal Authorities |
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ALTCS |
AAC R9-28-306 |