reglab/statecodes huggingface dataset:
Alaska Administrative Code › Title 7 - Health and Social Services › Part 6 - Miscellaneous › Chapter 86 - Health Care Services Price Transparency › 7 AAC 86.010 - Reporting the price of health care services.

Current through May 31, 2024
(a) A health care
				provider or health care facility that uses the American Medical Association's
Current Procedural Terminology (CPT)
codes in its normal
				course of business must annually compile a list and report to the department
				the health care services most commonly performed as required under
				AS
				18.23.400.
(b) A health care provider or health care
				facility must submit by electronic mail to the department the Internet address
				of the website containing its health care services price posting.
(c) A health care provider or health care
				facility that does not have an Internet website must submit a text version of
				the posting to the department by electronic mail. The text version must be sent
				in one of the following formats: portable document format (PDF), word
				processing (DOC, DOCX, ODT), presentation (PPT, PPTX, ODP), spreadsheet (XLS,
				XLSX, ODS), e-book (EPUB), text (TXT, CSV), or rich text format
				(RTF).
(d) The health care provider
				or health care facility must title the electronic mail and the attachment with
				the following convention: [Provider Name]_[Provider address]_[ Year]. [Format].
				The title may only contain the special characters of underscore, hyphen, and
				space. The titles may not include apostrophes, double quotes, or special
				characters. For example, an electronic mail and PDF heading for a hospital in
				Juneau would be formatted as "Hospital Name_3620 Hospital Drive
				Juneaii_20I9.PDF".
The electronic mail address for sending attachments is
					 DHSSpricereporting@alaska.gov.
Authority:
AS
					 18.05.040
AS
					 18.23.400
Alaska Administrative Code › Title 7 - Health and Social Services › Part 6 - Miscellaneous › Chapter 86 - Health Care Services Price Transparency › 7 AAC 86.020 - Posting the price for health care services

Current through May 31, 2024
(a) A health care
				provider or health care facility that uses the
Current Procedural
				Terminology (CPT).
codes in its normal course of business must post,
				as required under
				AS
				18.23.400, the price list for the health care
				services most commonly performed.
(b) When providing or posting price lists as
				required under
				AS
				18.23.400(e)(1) and (2), the
				health care provider or health facility must include the American Medical
				Association's copyright notice and disclaimer, using the following language:
				"CPT® Copyright 2020 [or insert applicable year]. American Medical
				Association. All rights reserved. CPT is a registered trademark of the American
				Medical Association. The CPT codes are provided "as is" without warranty of any
				kind. The AMA specifically disclaims all liability for use or accuracy of any
				CPT codes."
(c) A health care
				provider or health care facility must
(1)
				post the applicable health care services price list in a conspicuous space
				where a patient checks in and waits to see a health care provider;
(2) post the required price information on or
				before January 31 following the calendar year for which the health care price
				data was collected; and
(3) update
				the posting every year.
Alaska Administrative Code › Title 7 - Health and Social Services › Part 6 - Miscellaneous › Chapter 86 - Health Care Services Price Transparency › 7 AAC 86.030 - Good faith estimate

Current through May 31, 2024
(a) A health care provider or health care
				facility that receives a request under (b) or (c) of this section must provide
				a good faith estimate under
				AS
				18.23.400(g) and (h),
				regardless of whether the health care provider or health care facility uses CPT
				codes.
(b) To get a good faith
				estimate, a patient must provide the following information in writing to the
				health care provider or health care facility:
(1) the patient's full name;
(2) the medical condition or service for
				which the patient is seeking medical treatment;
(3) the method by which the patient prefers
				to receive the estimate, including in a written letter mailed to the patient,
				by electronic means, or orally; and
(4) the patient's contact information,
				including the patient's mailing address, electronic mail address, or telephone
				number.
Alaska Administrative Code › Title 7 - Health and Social Services › Part 6 - Miscellaneous › Chapter 86 - Health Care Services Price Transparency › 7 AAC 86.040 - Enforcement

Current through May 31, 2024
(a) If the department receives a report that
				a health care provider or health care facility has failed to comply with
				AS
				18.23.400 or this chapter, the department may
				investigate the matter. If the department determines that a health care
				provider or health care facility failed to comply, the department may contact
				the health care provider or health care facility by telephone to inform the
				provider or facility of the requirements of
				AS
				18.23.400 and this chapter.
(b) If the health care provider or health
				care facility fails to remedy noncompliance after being contacted under (a) of
				this section, the department may contact the health care provider or health
				care facility in writing, identifying how the health care provider or health
				care facility has failed to meet the requirements of
				AS
				18.23.400 and this chapter.
(c) If the health care provider or health
				care facility fails to comply after being contacted under (b) of this section,
				the department may issue a warning in writing to the health care provider or
				health care facility.
(d) If the
				health care provider or health care facility fails to comply after receiving a
				warning under (c) of this section, the department may assess a fine under
				AS
				18.23.400(k).
(e) The fine for a violation of
				AS
				18.23.400 and this chapter is $100 for each
				day of noncompliance, up to the $10,000 ceiling set under
				AS
				18.23.400(k).
Authority:
AS
					 18.05.040
AS
					 18.23.400
Alaska Administrative Code › Title 7 - Health and Social Services › Part 6 - Miscellaneous › Chapter 86 - Health Care Services Price Transparency › 7 AAC 86.090 - Definitions

Current through May 31, 2024
(a) In
				AS
				18.23.400, "plain language" means
				grammatically correct language that includes accurate word usage and
				communicates in a way that helps the public to easily understand the
				information.
(b) As used in the
				definition of "health care service" in
				AS
				18.23.400(n), "telemedicine"
				means the practice of health care delivery, evaluation, diagnosis,
				consultation, or treatment, using the transfer of medical data through audio,
				video, or data communications that are engaged in over two or more locations
				between providers who are physically separated from the patient or from each
				other.
Authority:
AS
					 18.23.400
Alaska Administrative Code › Title 7 - Health and Social Services › Part 7 - Medicaid Assistance Eligibility › Chapter 100 - Medicaid Eligibility › Article 1 - Common Medicaid Eligibility Requirements › 7 AAC 100.001 - Purpose

Current through May 31, 2024
The purpose of this chapter is to establish rules for
					 determining eligibility for Medicaid under AS 47.07. To be eligible for
					 Medicaid coverage under AS 47.07, an individual must qualify under this chapter
					 in an eligibility category listed in
					 7 AAC 100.002.
Authority:
AS
						47.05.010
AS 47.07.020
AS 47.07.030
AS
						47.07.040
Alaska Administrative Code › Title 7 - Health and Social Services › Part 7 - Medicaid Assistance Eligibility › Chapter 100 - Medicaid Eligibility › Article 1 - Common Medicaid Eligibility Requirements › 7 AAC 100.002 - Medicaid eligibility categories recognized in the state

Current through May 31, 2024
(a) Except as
				  provided in (b) of this section, the specific mandatory eligibility categories
				  required under
				  AS
				  47.07.020(a) for
				  individuals, children, and families are
(1)
				  households that
(A) meet the requirements of
				  42 U.S.C.
				  1396 a(a)(10)(A)(i)(I) and
				  42 U.S.C.
				  1396u-1; and
(B) are eligible for Family Medicaid under
				  7 AAC 100.100 -
				  7 AAC 100.199;
Alaska Administrative Code › Title 7 - Health and Social Services › Part 7 - Medicaid Assistance Eligibility › Chapter 100 - Medicaid Eligibility › Article 1 - Common Medicaid Eligibility Requirements › 7 AAC 100.004 - Identifiable application for Medicaid

Current through May 31, 2024
(a) The department
				  will not act on a request for Medicaid eligibility or coverage until the
				  department receives an identifiable application. An identifiable application
				  must be made on a form provided by the department for the purpose of applying
				  for Medicaid. That application form must
(1)
				  include
(A) a legible name and address;
				  and
(B) a signature or witness mark
				  of the applicant or the applicant's authorized representative appointed under
				  7 AAC 100.006(a);
Alaska Administrative Code › Title 7 - Health and Social Services › Part 7 - Medicaid Assistance Eligibility › Chapter 100 - Medicaid Eligibility › Article 1 - Common Medicaid Eligibility Requirements › 7 AAC 100.006 - Authorized representative and individual acting responsibly

Current through May 31, 2024
(a) An
				  applicant 18 years of age or older may appoint a representative who, in the
				  applicant's place, is authorized to apply for Medicaid on the applicant's
				  behalf. An individual who is 18 years of age or older may be an authorized
				  representative. The appointment of an authorized representative must be
(1) in writing; and
(2) signed and dated by the applicant and the
				  authorized representative; if, due to the level of literacy or competence, the
				  applicant's signature is only a mark, the mark must be witnessed by two
				  individuals who each date and sign their own name.
Alaska Administrative Code › Title 7 - Health and Social Services › Part 7 - Medicaid Assistance Eligibility › Chapter 100 - Medicaid Eligibility › Article 1 - Common Medicaid Eligibility Requirements › 7 AAC 100.008 - When a new application is required

Current through May 31, 2024
(a) A new
				  application must be made if, at the time of application, the individual is not
				  receiving Medicaid under this chapter and is not a member of a household
				  receiving Medicaid under this chapter.
(b) The department may determine eligibility
				  without requiring the applicant or recipient to submit a new application under
				  the following circumstances if the department already has enough information to
				  determine eligibility:
(1) a recipient is
				  moving from one eligibility category to another eligibility category;
(2) an individual is being added to an
				  ongoing Medicaid case and the caseworker is able to obtain all other needed
				  verification and documentation;
(3)
				  an individual is already receiving benefits administered by the division
				  handling public assistance within the department, and the existing public
				  assistance record contains enough information to determine Medicaid
				  eligibility;
(4) a household moves
				  from Family Medicaid to Transitional Medicaid or from Transitional Medicaid to
				  Family Medicaid;
(5) a child who
				  has been eligible under a category in
				  7 AAC 100.002(a) or (c) related to
				  Family Medicaid moves to the disability-related eligibility category in
				  7 AAC 100.002(d) (5);
(6) an individual submits a Medicaid
				  application form designed for a different Medicaid eligibility category than
				  the one intended, but the application form submitted contains enough
				  information for the department to determine eligibility for the intended
				  category;
(7) the department is
				  reinstating benefits for a recipient whose Medicaid eligibility was terminated,
				  if the recipient has made a timely request for a hearing under 7 AAC 49, or
				  reinstatement of eligibility is ordered under 7 AAC 49 or by the
				  court.
Alaska Administrative Code › Title 7 - Health and Social Services › Part 7 - Medicaid Assistance Eligibility › Chapter 100 - Medicaid Eligibility › Article 1 - Common Medicaid Eligibility Requirements › 7 AAC 100.012 - Disposition of application

Current through May 31, 2024
(a) The department
				  will make a finding of eligibility or ineligibility for every identifiable
				  application for Medicaid that it receives under
				  7 AAC 100.004, unless
(1) a written request to withdraw the
				  application is submitted by an individual authorized to sign the application
				  under 7 AAC 100.004(b);
(2) the department has factual information
				  confirming the death of the applicant; or
(3) the applicant cannot be
				  located.
Alaska Administrative Code › Title 7 - Health and Social Services › Part 7 - Medicaid Assistance Eligibility › Chapter 100 - Medicaid Eligibility › Article 1 - Common Medicaid Eligibility Requirements › 7 AAC 100.014 - Interview required

Current through May 31, 2024
(a) An applicant for Medicaid under one of
				  the following eligibility categories must participate in at least one
				  face-to-face interview with a caseworker or fee agent, unless waived by the
				  department under (c) of this section:
(1)
				  Family Medicaid under
				  7 AAC 100.002(a) (1);
(2) Family Medicaid-related eligibility under
				  7 AAC 100.002(a) (2), (3), or (10) or (c)(1), (2), or (7);
(3) under-21 Medicaid under
				  7 AAC 100.002(c) (2) - (4);
(4) any APA-related Medicaid eligibility
				  category under
				  7 AAC 100.002(b), (d), or (e).
Alaska Administrative Code › Title 7 - Health and Social Services › Part 7 - Medicaid Assistance Eligibility › Chapter 100 - Medicaid Eligibility › Article 1 - Common Medicaid Eligibility Requirements › 7 AAC 100.016 - Verification and documentation

Current through May 31, 2024
(a) The department
				  will verify whether an applicant or recipient meets eligibility
				  requirements.
(b) The department
				  will request in writing that an applicant or recipient provide documentation
				  that the applicant or recipient meets eligibility requirements if the required
				  documentation is not readily available to the department from any alternative
				  source or the information needed cannot be verified from an alternative source
				  readily available to the department. Except as provided in
				  7 AAC 100.030, an applicant or a recipient who refuses
				  to provide the department with documentation under this section will be
				  determined ineligible for Medicaid by the department.
(c) The department will determine whether the
				  verification and documentation supports a finding of eligibility by evaluating
				  whether
(1) it reasonably proves the fact in
				  question;
(2) it is consistent with
				  all other information contained in the application and record; and
(3) alternative types of verification or
				  documentation, if necessary, are obtainable.
Alaska Administrative Code › Title 7 - Health and Social Services › Part 7 - Medicaid Assistance Eligibility › Chapter 100 - Medicaid Eligibility › Article 1 - Common Medicaid Eligibility Requirements › 7 AAC 100.018 - Application processing, timeframes, and notices

Current through May 31, 2024
(a) No later than
				  30 days after an application is received, or 90 days if a disability
				  determination is required, a district office of the division handling public
				  assistance matters in the department or the office of the department handling
				  matters for children in the department's protective custody or supervision
				  shall mail a notice to the applicant
(1)
				  indicating that the applicant is either eligible or ineligible for
				  benefits;
(2) requesting additional
				  information or documentation if necessary to determine eligibility;
				  or
(3) confirming that the
				  application was withdrawn as provided in
				  7 AAC 100.012.
Alaska Administrative Code › Title 7 - Health and Social Services › Part 7 - Medicaid Assistance Eligibility › Chapter 100 - Medicaid Eligibility › Article 1 - Common Medicaid Eligibility Requirements › 7 AAC 100.020 - Review application requirements

Current through May 31, 2024
(a) Except as
				  provided in (h) of this section, at least once every 12 months, the department
				  will require a recipient who is eligible for Medicaid to submit a review
				  application on a form provided by the department and furnish the documentation
				  requested by the department to support continued eligibility.
(b) Repealed 10/1/2009.
(c) Repealed 4/1/2009.
(d) The department will notify a recipient or
				  a known person acting on the recipient's behalf that a review of the
				  recipient's eligibility is required and the date on or before which the
				  recipient must submit the recipient's review application. In the notice, the
				  department will state that failure to submit a review application on or before
				  the date stated in the notice will result in the recipient's loss of
				  eligibility under (e) of this section.
(e) Except as provided in
				  7 AAC 100.070 and (f) of this section, if a recipient
				  fails to submit a review application on or before the date indicated in the
				  notice under (d) of this section, the recipient will lose Medicaid
				  eligibility.
(f) If a recipient is
				  receiving SSI, the department will continue that recipient's Medicaid
				  eligibility until the department receives verification that the recipient has
				  ceased getting SSI or has moved out of the state, even if the recipient fails
				  to submit the recipient's review application.
(g) The department may set a recipient's
				  review period of less than the duration set in (a) of this section to establish
				  a review date that coincides with a level of care review date, home and
				  community-based waiver services review date, or other significant date related
				  to that recipient's continued eligibility for Medicaid or other programs
				  administered by the department.
(h)
				  Notwithstanding the review periods established in (a) - (g) of this section,
				  upon receipt of information from any source that indicates that a change in
				  circumstances affecting a recipient's continued eligibility may have occurred,
				  the department will investigate and may require that a review application be
				  completed.
(i) If additional
				  verification or documentation is necessary to support continued eligibility
				  under this section, the department will act in accordance with
				  7 AAC 100.016.
(j) In this section,
(1) "review date" means the date marking the
				  end of a review period and the end of a recipient's Medicaid eligibility for or
				  authorization for services if the department does not redetermine the
				  recipient's eligibility under this chapter;
(2) "review period" means the period of time
				  a recipient is eligible for Medicaid without the department redetermining the
				  recipient's Medicaid eligibility.
Alaska Administrative Code › Title 7 - Health and Social Services › Part 7 - Medicaid Assistance Eligibility › Chapter 100 - Medicaid Eligibility › Article 1 - Common Medicaid Eligibility Requirements › 7 AAC 100.030 - Social security number

Current through May 31, 2024
(a) Except as
				  provided in (d) of this section, to be eligible for Medicaid an applicant must
				  do one of the following:
(1) present to the
				  department or a fee agent the applicant's actual social security card or a
				  photocopy of it;
(2) submit a
				  written statement giving the applicant's social security number;
(3) enter the applicant's social security
				  number on the Medicaid application form;
(4) complete a federal Social Security
				  Administration form applying for a number, and comply with all Social Security
				  Administration requirements for completion of the form;
(5) show proof of an application for a social
				  security number as part of the state's birth registration process.
Alaska Administrative Code › Title 7 - Health and Social Services › Part 7 - Medicaid Assistance Eligibility › Chapter 100 - Medicaid Eligibility › Article 1 - Common Medicaid Eligibility Requirements › 7 AAC 100.032 - Development of income

Current through May 31, 2024
(a) Except as
				  otherwise provided in this section, to be eligible for Medicaid, a member of a
				  household who may be eligible for benefits under one or more of the following
				  programs must apply for and, if eligible, accept benefits from that program:
(1) workers' compensation under AS
				  23.30;
(2) social security
				  disability, old-age, or survivor's benefits under
				  42 U.S.C.
				  401-
				  434;
(3) United States Department of Veterans
				  Affairs benefits under 38
				  U.S.C. 101-
				  8528;
(4) civil service disability and retirement
				  under 5 U.S.C.
				  8101-
				  9009;
(5) railroad disability and retirement under
				  4  5 U.S.C.
				  231-
				  231e ;
(6) government or private retirement
				  programs;
(7) unemployment
				  insurance benefits under
				  AS
				  23.20.330-23.20.405.
Alaska Administrative Code › Title 7 - Health and Social Services › Part 7 - Medicaid Assistance Eligibility › Chapter 100 - Medicaid Eligibility › Article 1 - Common Medicaid Eligibility Requirements › 7 AAC 100.034 - Assignment of rights to third-party payment

Current through May 31, 2024
(a) To be eligible
				  for Medicaid, an applicant or recipient must
(1) cooperate with the department in
				  obtaining or identifying third-party resources that may be available to pay for
				  medical care for which Medicaid coverage is sought; and
(2) assign to the department the applicant's
				  or recipient's rights to payment for medical care from a third party for which
				  Medicaid coverage is sought.
Alaska Administrative Code › Title 7 - Health and Social Services › Part 7 - Medicaid Assistance Eligibility › Chapter 100 - Medicaid Eligibility › Article 1 - Common Medicaid Eligibility Requirements › 7 AAC 100.040 - Medical support assignment

Current through May 31, 2024
(a) A custodial
				  parent or guardian of a child who is a Medicaid applicant or recipient must
				  assign to the state the right to receive and retain medical support from a
				  noncustodial parent on behalf of all children for whom the applicant is seeking
				  Medicaid benefits.
(b) Signing an
				  application for Medicaid on a form provided by the department constitutes
				  assignment of the applicant's rights to medical support from a noncustodial
				  parent and is effective upon a determination that the applicant or recipient is
				  eligible to receive Medicaid.
Authority:
AS
						47.05.010
AS 47.07.025
AS
						47.07.040
Alaska Administrative Code › Title 7 - Health and Social Services › Part 7 - Medicaid Assistance Eligibility › Chapter 100 - Medicaid Eligibility › Article 1 - Common Medicaid Eligibility Requirements › 7 AAC 100.042 - Medical support cooperation

Current through May 31, 2024
(a) Except as
				  otherwise provided in this section, an applicant for Medicaid who is 18 years
				  of age or older and who is a parent, or who can legally assign rights to
				  medical support for a child in the applicant's care, must cooperate with the
				  child support services agency of the Department of Revenue in accordance with
				  this section. This subsection also applies to an adult who is a Medicaid
				  recipient under any APA-related Medicaid eligibility category identified in
				  7 AAC 100.002(b), (d), or (e) and who
				  is applying for Medicaid on behalf of that recipient's own child or a child for
				  whom the recipient is a guardian.
(b) For the purpose of determining Medicaid
				  eligibility under this chapter, the following individuals are not required to
				  cooperate with the child support services agency:
(1) a pregnant woman who is applying only for
				  herself through the end of her postpartum period under
				  7 AAC 100.304;
(2) an applicant who is under 21 years of age
				  and is applying for medical assistance only for the applicant, regardless of
				  the applicant's living arrangement;
(3) an applicant who is under 18 years of age
				  who is applying on behalf of the applicant's own child;
(4) an applicant who is applying on behalf of
				  a child who is an American Indian, Alaska Native, or other beneficiary of
				  health care services from the United States Department of Health and Human
				  Services, Indian Health Service, or from a tribal organization funded in whole
				  or in part by the Indian Health Service, if those services are reasonably
				  available;
(5) a custodial parent
				  who is applying on behalf of a child who is already covered under either the
				  custodial or noncustodial parent's third-party health insurance;
(6) a caretaker relative who cannot legally
				  assign rights to payment for medical care for a child in the caretaker
				  relative's care for whom the caretaker relative is applying;
(7) an individual for whom the department has
				  found, under
				  7 AAC 100.044, good cause for refusal to cooperate with
				  the child support services agency.
Alaska Administrative Code › Title 7 - Health and Social Services › Part 7 - Medicaid Assistance Eligibility › Chapter 100 - Medicaid Eligibility › Article 1 - Common Medicaid Eligibility Requirements › 7 AAC 100.044 - Good cause for refusal to cooperate with child support services agency

Current through May 31, 2024
(a) In
				  accordance with
				  7 AAC 100.042(b) (7), the department
				  will find that good cause for refusal to cooperate with the child support
				  services agency exists if
(1) cooperation
				  would increase the risk of physical harm to the child, custodial parent, or
				  caretaker relative;
(2) cooperation
				  would increase the risk of emotional harm to the child, custodial parent, or
				  caretaker relative that would reduce the custodial parent's or caretaker
				  relative's ability to care for the child adequately; or
(3) proceedings to establish paternity or to
				  secure medical support would be detrimental to the child because
(A) the child was conceived as a result of
				  incest or as a result of an action that would constitute the crime of sexual
				  assault in the first degree, as defined in
				  AS
				  11.41.410;
(B) legal proceedings for adoption of the
				  child are pending before a court; or
(C) the custodial parent or caretaker
				  relative is currently being assisted by a public or licensed private social
				  service agency to resolve the issue of whether to keep the child or to
				  relinquish the child for adoption.
Alaska Administrative Code › Title 7 - Health and Social Services › Part 7 - Medicaid Assistance Eligibility › Chapter 100 - Medicaid Eligibility › Article 1 - Common Medicaid Eligibility Requirements › 7 AAC 100.046 - Failure to cooperate with medical support enforcement

Current through May 31, 2024
(a) A parent or
				  other adult who is required to cooperate with the child support services
				  agency, but who fails to do so without good cause, is ineligible for Medicaid
				  until the parent or adult cooperates as required. Only a parent or other adult
				  who can legally assign rights to medical support and who is, or could be, a
				  Medicaid recipient may incur a loss of Medicaid benefits for refusal to
				  cooperate with the child support services agency.
(b) To assure that a child is not made
				  ineligible because of a parent's or other adult's noncooperation with the child
				  support services agency, the department will apply the following rules when
				  determining a child's Medicaid eligibility:
(1) for poverty-level children eligibility
				  categories under
				  7 AAC 100.002(a) (6) - (7) and
				  7 AAC 100.002(c) (8), the financial
				  needs of the noncooperating parent are included in determining the household
				  size;
(2) for Family Medicaid under
				  7 AAC 100.002(a) (1), and for
				  eligibility under
				  7 AAC 100.002(c) (1), the need, income,
				  and resources of the noncooperating parent who is a mandatory member of the
				  household under
				  7 AAC 100.104 are included in determining the household
				  size, income, and resources, but the parent is ineligible for
				  Medicaid;
(3) for Family Medicaid
				  under 7 AAC 100.002(a) (1) and
				  7 AAC 100.002(c) (1), if a caretaker
				  relative who is an optional member of the household under
				  7 AAC 100.116 is required to cooperate but does not
				  cooperate, the financial needs, income, and resources of that caretaker
				  relative are not included in the household;
(4) for under-21 Medicaid under
				  7 AAC 100.002(c) (2) - (4), an
				  individual who is 19 or 20 years old who applies for Medicaid for the
				  individual's own child and who fails to cooperate with the child support
				  services agency without good cause is ineligible for under-21
				  Medicaid.
Alaska Administrative Code › Title 7 - Health and Social Services › Part 7 - Medicaid Assistance Eligibility › Chapter 100 - Medicaid Eligibility › Article 1 - Common Medicaid Eligibility Requirements › 7 AAC 100.050 - Citizenship and alien status

Current through May 31, 2024
(a) To be eligible
				  for Medicaid, an individual must meet all other eligibility requirements under
				  this chapter, including the state residency requirement under
				  7 AAC 100.060, and
(1)
				  be or claim to be a United States citizen under
				  7 AAC 100.054;
(2) be a qualified alien described in
				  7 AAC 100.052; or
(3) be one of the following North American
				  Indians with lawful immigration status:
(A)
				  Canadian Indians with at least 50 percent American Indian blood who are given
				  special status under 8 U.S.C.
				  1359 and are exempt from immigrant
				  registration or visa requirements;
(B) individuals who are not United States
				  citizens but who are members of an Indian tribe.
Alaska Administrative Code › Title 7 - Health and Social Services › Part 7 - Medicaid Assistance Eligibility › Chapter 100 - Medicaid Eligibility › Article 1 - Common Medicaid Eligibility Requirements › 7 AAC 100.052 - Qualified aliens

Current through May 31, 2024
(a) Medicaid eligibility for an alien is
				  based on whether the alien is a qualified alien or nonqualified alien,
				  regardless of the date of that alien's physical entry into the United
				  States.
(b) A qualified alien is an
				  alien who, at the time the alien applies for or receives a Medicaid benefit, is
(1) a qualified alien as defined in
				  8 U.S.C.
				  1641;
(2) a victim of a severe form of trafficking
				  in persons, and family members of the victim, who under
				  22 U.S.C.
				  7105 are eligible for Medicaid benefits to
				  the same extent as refugees described in
				  8 U.S.C.
				  1641(b)(3); or
(3) an Iraqi or Afghan alien, or the
				  dependent of that alien, who is granted special immigrant status under
				  8 U.S.C.
				  1101(a)(27).
Alaska Administrative Code › Title 7 - Health and Social Services › Part 7 - Medicaid Assistance Eligibility › Chapter 100 - Medicaid Eligibility › Article 1 - Common Medicaid Eligibility Requirements › 7 AAC 100.054 - Verifying identity and United States citizenship

Current through May 31, 2024
(a) If the
				  department is unable to verify both identity and United States citizenship
				  through a data match with the United States Social Security Administration, an
				  applicant for Medicaid may verify both identity and United States citizenship
				  by submitting to the department
(1) a United
				  States passport that was issued by the United States Department of State
				  without limitation;
(2) a
				  certificate of naturalization from the United States Department of Homeland
				  Security;
(3) a certificate of
				  United States citizenship from the United States Department of Homeland
				  Security; or
(4) a document issued
				  by an Indian tribe that shows membership in, enrollment in, or affiliation with
				  that tribe; documentation may include a tribal enrollment card or certificate
				  of degree of Indian blood.
Alaska Administrative Code › Title 7 - Health and Social Services › Part 7 - Medicaid Assistance Eligibility › Chapter 100 - Medicaid Eligibility › Article 1 - Common Medicaid Eligibility Requirements › 7 AAC 100.056 - Five-year bar

Current through May 31, 2024
(a) Unless exempt under
				  7 AAC 100.058, a qualified alien as described in
				  7 AAC 100.052 who enters the United States on or after
				  August 22, 1996, is not eligible for Medicaid for a period of five years
				  beginning on the date the alien physically entered into the United States. A
				  nonqualified alien who enters the United States on or after August 22, 1996,
				  must obtain qualified alien status before the five-year bar begins. The
				  five-year bar begins on the date the nonqualified alien obtains qualified alien
				  status, not the date the alien physically entered the United States.
(b) The department will determine if an alien
				  who arrived in the United States before August 22, 1996, is a qualified alien.
				  If the alien was admitted as a qualified alien before August 22, 1996, the
				  five-year bar does not apply. If the alien was admitted as a nonqualified alien
				  before August 22, 1996, and has since obtained qualified alien status, the
				  alien is not subject to the five-year bar if the alien remained continuously
				  present in the United States while a nonqualified alien. Any single absence
				  from the United States of more than 30 days, or a total aggregate of absences
				  of more than 90 days, interrupts continuous presence. Once an alien who entered
				  the United States after August 22, 1996, obtains qualified alien status, the
				  alien does not have to remain continuously present in the United States in
				  order to avoid application of the five-year bar. For the purposes of this
				  subsection, an alien who entered the United States without proper documentation
				  or who overstayed the alien's visa is a nonqualified alien.
Authority:
AS
						47.05.010
AS 47.07.020
AS
						47.07.040
Alaska Administrative Code › Title 7 - Health and Social Services › Part 7 - Medicaid Assistance Eligibility › Chapter 100 - Medicaid Eligibility › Article 1 - Common Medicaid Eligibility Requirements › 7 AAC 100.058 - Aliens exempt from the five-year bar

Current through May 31, 2024
The five-year bar described in
					 7 AAC 100.056 does not apply to an alien who is
(1) a refugee granted asylum or an individual
				  with a similar status described in
				  8 U.S.C.
				  1613(b)(1);
(2) a veteran of, or who is on active duty
				  in, the United States armed forces as described in
				  8 U.S.C.
				  1613(b)(2);
(3) an individual who is Hmong or from
				  another Highland Lao tribal people who fought on behalf of the armed forces of
				  the United States during the Vietnam conflict and who has been lawfully
				  admitted to the United States as a permanent resident; in accordance with the
				  congressional statement of intent in
				  sec.
				  5566 of
				  P.L.
				  105-33 (the Balanced Budget Act of 1997), the
				  alien identified in this paragraph is considered a veteran with the same status
				  as a veteran identified in (2) of this section;
(4) an immediate family member, as described
				  in 8 U.S.C.
				  1613(b)(2)(C), of an
				  individual in (2) or (3) of this section;
(5) a victim of a severe form of trafficking
				  in persons, and family members of the victim, who under
				  22 U.S.C.
				  7105 are eligible for Medicaid benefits to
				  the same extent as refugees described in
				  8 U.S.C.
				  1641(b)(3);
(6) a North American Indian identified in
				  7 AAC 100.050(a) (3); or
(7) an Afghan or Iraqi alien and the
				  dependents of that alien who are granted special immigrant status under
				  8 U.S.C.
				  1101(a)(27).
Authority:
AS
						47.05.010
AS 47.07.020
AS
						47.07.040
Alaska Administrative Code › Title 7 - Health and Social Services › Part 7 - Medicaid Assistance Eligibility › Chapter 100 - Medicaid Eligibility › Article 1 - Common Medicaid Eligibility Requirements › 7 AAC 100.060 - State residency

Current through May 31, 2024
(a) To be eligible for Medicaid in this state
				  an applicant must be a resident of the state.
(b) Except as otherwise provided in (c) in
				  this section, a resident of the state is an individual who is physically
				  present in the state and living in the state voluntarily with the intent to
				  remain in the state permanently or for an indefinite period of time. The
				  department will determine if an individual is a resident of the state using the
				  methodology established in 42 C.F.R. 435.403, revised as of
				  October 1, 2005, and adopted by reference.
(c) An individual currently in the state who
				  plans to leave the state after a short period of time, including a migrant
				  worker, is a resident of the state for the purposes of Medicaid if that
				  individual
(1) lives in the state on the date
				  of application;
(2) is not
				  receiving public assistance from another state; and
(3) entered the state with employment, or the
				  intent to find employment, regardless of whether the individual is actually
				  employed at the time of application.
Alaska Administrative Code › Title 7 - Health and Social Services › Part 7 - Medicaid Assistance Eligibility › Chapter 100 - Medicaid Eligibility › Article 1 - Common Medicaid Eligibility Requirements › 7 AAC 100.062 - Receiving assistance from another state

Current through May 31, 2024
(a) An applicant
				  who has recently arrived in the state with the intent to remain and who is
				  still receiving assistance from another state meets the residency requirement
				  of 7 AAC 100.060. However, the
				  department will not issue Medicaid benefits until Medicaid benefits from the
				  other state are terminated, unless the department verifies that
(1) the other state was unable to or did not
				  stop the issuance of Medicaid benefits before the individual arrived in this
				  state; and
(2) the applicant did
				  not use the benefits issued from the other state to pay for any medical
				  services provided in the month.
Alaska Administrative Code › Title 7 - Health and Social Services › Part 7 - Medicaid Assistance Eligibility › Chapter 100 - Medicaid Eligibility › Article 1 - Common Medicaid Eligibility Requirements › 7 AAC 100.064 - Temporary absence from the state

Current through May 31, 2024
(a) An applicant
				  for or recipient of Medicaid benefits continues to be a resident of the state
				  while the applicant or recipient is temporarily absent from the state if
(1) the applicant or recipient intends to
				  return to the state when the purpose of the absence has been accomplished;
				  and
(2) no other state has
				  determined that the applicant or recipient is a resident of the other state for
				  the purpose of receiving Medicaid or other public benefits.
Alaska Administrative Code › Title 7 - Health and Social Services › Part 7 - Medicaid Assistance Eligibility › Chapter 100 - Medicaid Eligibility › Article 1 - Common Medicaid Eligibility Requirements › 7 AAC 100.066 - Residency and out-of-state placement

Current through May 31, 2024
(a) If a Medicaid
				  recipient is placed in an institution located in another state, the state of
				  residence is determined according to
				  42 C.F.R.
				  435.403, revised as of October 1, 2005, and
				  adopted by reference.
(b) If a
				  recipient leaves an institution or foster care setting and also leaves the
				  legal custody of this state, the state of residence is the state where the
				  individual is physically located. If that recipient intends to return to the
				  state but remains out of state temporarily for follow-up or transitional care
				  called for in the recipient's treatment plan, that individual is considered
				  only to be temporarily absent and remains a resident of this state.
Authority:
AS
						47.05.010
AS 47.07.020
AS
						47.07.040
Alaska Administrative Code › Title 7 - Health and Social Services › Part 7 - Medicaid Assistance Eligibility › Chapter 100 - Medicaid Eligibility › Article 1 - Common Medicaid Eligibility Requirements › 7 AAC 100.068 - Living in a public institution

Current through May 31, 2024
(a) Except as
				  provided in this section, the department will not reimburse Medicaid services
				  provided to a Medicaid-eligible individual while the individual resides in a
				  public institution, regardless of whether placement was voluntary or
				  involuntary, unless the individual is
(1)
				  living in a public institution solely to receive educational or vocational
				  training;
(2) placed in a public
				  institution on a short-term emergency basis pending placement in a living
				  arrangement appropriate to the individual's needs;
(3) living in a correctional facility or
				  juvenile facility but received medical care while an inpatient in a medical
				  institution for at least 24 hours; or
(4) living in a substance abuse treatment
				  facility or a halfway house that has a contract with the state to provide
				  treatment and monitoring.
Alaska Administrative Code › Title 7 - Health and Social Services › Part 7 - Medicaid Assistance Eligibility › Chapter 100 - Medicaid Eligibility › Article 1 - Common Medicaid Eligibility Requirements › 7 AAC 100.070 - Continuous eligibility for children

Current through May 31, 2024
(a) Except as
				  provided in (b) and (c) of this section, a child under 19 years of age who is
				  eligible for Medicaid remains eligible for Medicaid for a continuous
				  12-calendar-month period beginning with the month a prospective eligibility
				  determination is made. Each time a new prospective eligibility determination is
				  made a new 12-calendar-month period begins. During a continuous eligibility
				  period a child continues to be eligible regardless of changes in income,
				  resources, family status, or household composition.
(b) The 12-calendar-month continuous
				  eligibility period provided in this section is not available to a child who is
				  eligible for Medicaid under
(1) any of the
				  following eligibility categories:
(A) newborns
				  under 7 AAC 100.002(a) (5);
(B) children in the eligibility category
				  described in
				  7 AAC 100.002(a) (3);
(C) children in the eligibility category
				  described in
				  7 AAC 100.002(a) (2) (Transitional
				  Medicaid); or
Alaska Administrative Code › Title 7 - Health and Social Services › Part 7 - Medicaid Assistance Eligibility › Chapter 100 - Medicaid Eligibility › Article 1 - Common Medicaid Eligibility Requirements › 7 AAC 100.072 - Retroactive Medicaid eligibility

Current through May 31, 2024
(a) At the time of
				  application or interview, an applicant may request Medicaid coverage for a
				  maximum of three months immediately preceding the month of application if the
				  applicant has unpaid medical expenses for dates of service any time during that
				  three-month period.
(b) The
				  department will inform the applicant about potential retroactive coverage under
				  this section as part of the application and interview process.
(c) Eligibility must be determined separately
				  for each retroactive month in which the applicant seeks coverage. The applicant
				  need not be eligible for Medicaid in the month of application to be found
				  eligible in any of the retroactive months. An application for retroactive
				  Medicaid may be filed on behalf of an individual who is deceased at the time of
				  application.
(d) The department
				  will use the income and resource methodology of the eligibility category for
				  which the applicant is applying to determine the following:
(1) actual income received in the
				  month;
(2) actual self-employment
				  income for the month as determined under
				  7 AAC 100.172 and
				  7 AAC 100.174;
(3) actual resources that were available in
				  that month.
Alaska Administrative Code › Title 7 - Health and Social Services › Part 7 - Medicaid Assistance Eligibility › Chapter 100 - Medicaid Eligibility › Article 1 - Common Medicaid Eligibility Requirements › 7 AAC 100.074 - Suspension for temporary ineligibility

Current through May 31, 2024
The department will suspend, rather than terminate, an
					 individual or household's eligibility if the individual or household is likely
					 to be ineligible for only one month. The department will not count the
					 suspension month as a month in which earned income deductions are allowed under
					 7 AAC 100.184.
Authority:
AS
						47.05.010
AS 47.07.020
AS
						47.07.040
Alaska Administrative Code › Title 7 - Health and Social Services › Part 7 - Medicaid Assistance Eligibility › Chapter 100 - Medicaid Eligibility › Article 2 - Family Medicaid › 7 AAC 100.100 - Family Medicaid and related eligibility categories

Current through May 31, 2024
The provisions of
					 7 AAC 100.100 -
					 7 AAC 100.199 establish Family Medicaid eligibility
					 criteria under
					 7 AAC 100.002(a) (1). Except as
					 otherwise provided in this chapter,
					 7 AAC 100.100 -
					 7 AAC 100.199 apply to all eligibility categories under
					 7 AAC 100.002(a) or (c).
Authority:
AS
						47.05.010
AS 47.07.020
AS
						47.07.040
Alaska Administrative Code › Title 7 - Health and Social Services › Part 7 - Medicaid Assistance Eligibility › Chapter 100 - Medicaid Eligibility › Article 2 - Family Medicaid › 7 AAC 100.102 - Determining eligibility

Current through May 31, 2024
(a) To determine
				  eligibility for Family Medicaid, the department will first determine who is in
				  the Family Medicaid household under (b) of this section and then determine if
				  the household is financially eligible under (c) of this section.
(b) A Family Medicaid household is the
				  combination of individuals whose financial needs the department considers for
				  the purpose of determining eligibility. A Family Medicaid household includes
(1) all mandatory members of the household as
				  described in
				  7 AAC 100.104;
(2) optional members of the household who may
				  be included in the household under
				  7 AAC 100.116; and
(3) any individual who is required to have
				  the individual's financial needs, income, and resources included in the
				  financial eligibility determination, even though that individual does not
				  receive Medicaid benefits for reasons identified in
				  7 AAC 100.120(b).
Alaska Administrative Code › Title 7 - Health and Social Services › Part 7 - Medicaid Assistance Eligibility › Chapter 100 - Medicaid Eligibility › Article 2 - Family Medicaid › 7 AAC 100.104 - Mandatory members of the household

Current through May 31, 2024
(a) Unless
				  otherwise provided in this chapter, the following individuals are mandatory
				  members for the household for the purposes of determining Family Medicaid
				  eligibility if they are living in the same home:
(1) a dependent child; to be determined a
				  dependent child, an individual must be deprived of parental support and care
				  under 7 AAC 100.106, and must be
(A) under 18 years of age; or
(B) under 19 years of age and enrolled
				  full-time in a secondary school or in the equivalent vocational or technical
				  training;
Alaska Administrative Code › Title 7 - Health and Social Services › Part 7 - Medicaid Assistance Eligibility › Chapter 100 - Medicaid Eligibility › Article 2 - Family Medicaid › 7 AAC 100.106 - Deprivation

Current through May 31, 2024
(a) To be eligible for Family Medicaid, a
				  dependent child must be deprived of the parental support and care of one or
				  both of the child's parents. Deprivation occurs
(1) when a parent does not continue to live
				  in the home of the child, except for a temporary absence authorized under
				  7 AAC 100.112; or
(2) because of deficient employment of a
				  parent.