Alaska Administrative Code

The Chronic and Acute Medical Assistance (CAMA) program is designed to pay, in accordance with AS 47.08.150 and this chapter, health care providers who provide covered medical services to eligible chronically ill, needy persons suffering from certain chronic or acute medical cond…

(a) An individual, or a person acting on that individual's behalf, may apply for assistance under the CAMA program by submitting a complete identifiable application. (b) Repealed 11/1/2002. (c) A caseworker must interview the applicant before eligibility can be determined unless …

The department will make an eligibility determination in accordance with 7 AAC 47.050 and 7 AAC 47.070, which are adopted by reference as revised as of July 31, 1998. Notes 7 AAC 48.510 Eff. 7/1/98, Register 147; am 11/27/98, Register 148; am 2/1/2010, Register 193 Authority:AS 4…

(a) The period of CAMA eligibility is one calendar month, unless the department, in its discretion, extends the eligibility period. However, the department may not extend an eligibility period longer than six consecutive calendar months. At the expiration of the eligibility perio…

A recipient shall comply with 7 AAC 47.080, which is adopted by reference as revised as of July 31, 1998. Notes 7 AAC 48.520 Eff. 7/1/98, Register 147; am 11/27/98, Register 148 Authority:AS 47.05.010 AS 47.08.150 State regulations are updated quarterly; we currently have two ver…

(a) The department will determine eligibility for CAMA based upon the following: (1) financial need; (2) lack of income to meet that financial need; (3) lack of prior or personal resources; (4) age; (5) residency in this state at the time of application; (6) United States citizen…

(a) In addition to including the financial need, income, and resources of the applicant, the spouse, child, parent, grandparent, grandchild, or sibling of an applicant for CAMA is liable for the support of that applicant, and will have their financial needs, income, and resources…

The department will determine a CAMA applicant's access to prior resources available to meet the specific medical need or personal resources in accordance with 7 AAC 47.160, which is adopted by reference as revised as of July 31, 1998. Notes 7 AAC 48.535 Eff. 7/1/98, Register 147…

An applicant for CAMA shall demonstrate financial need in accordance with 7 AAC 47.150(b) -(c) and 7 AAC 47.155, which are adopted by reference as revised as of July 31, 1998. Notes 7 AAC 48.540 Eff. 7/1/98, Register 147; am 11/27/98, Register 148 Authority:AS 47.05.010 AS 47.08.…

The department will provide a written certification of eligibility for CAMA in accordance with 7 AAC 47.180, which is adopted by reference as revised as of July 31, 1998. Notes 7 AAC 48.545 Eff. 7/1/98, Register 147; am 11/27/98, Register 148; am 2/1/2010, Register 193 Authority:…

(a) The department will pay for services furnished to eligible recipients under 7 AAC 48.525(b), subject to the limits set out in this section and in 7 AAC 48.555 - 7 AAC 48.590. (b) Medical services furnished under the CAMA program are subject to the same limits placed on the am…

For services furnished on or after July 1, 2004, the department will not make a payment under the CAMA program for any expense that is (1) for major medical care; (2) for nursing facility care; (3) for items and services not properly prescribed or determined necessary by a health…

(a) Except as provided in this section, the department will pay for prescribed drugs and medical supplies in accordance with 7 AAC 47.271, revised as of July 31, 1998, adopted by reference. (b) Subject to 7 AAC 48.550(c), for prescriptions filled or refilled on or after July 1, 2…

Repealed 9/20/2003. Notes 7 AAC 48.565 Eff. 7/1/98, Register 147; am 11/27/98, Register 148; am 11/1/2002, Register 164; repealed 9/20/2003, Register 167 State regulations are updated quarterly; we currently have two versions available. Below is a comparison between our most rece…

(a) The recipient bears the responsibilities listed in 7 AAC 47.220(a), and is responsible for all charges incurred for services that are not covered under 7 AAC 48 and the charges listed in 7 AAC 47.220(b). (b) The department will restrict a recipient's choice of provider in acc…

An applicant for CAMA shall provide information and assign rights as described for the General Relief Medical program at 7 AAC 47.260, which is adopted by reference as revised as of July 31, 1998. Notes 7 AAC 48.575 Eff. 7/1/98, Register 147; am 11/27/98, Register 148 Authority:A…

Health care providers under the CAMA program are bound by the provisions of 7 AAC 48.500 - 7 AAC 48.900 and the provisions of 7 AAC 105 - 7 AAC 160. If the provisions of 7 AAC 48.500 - 7 AAC 48.900 conflict with provisions of 7 AAC 105 - 7 AAC 160, the provisions of 7 AAC 48.500 …

(a) Claims for payment must be filed with the fiscal intermediary on contract with the department within 12 months of the date of service to be considered for payment. (b) Payment will be made in the amount determined under the provisions of 7 AAC 105 - 7 AAC 160. (c) Repealed 9/…

The department will pay the provider directly for medical services under the CAMA program. The department will not make payments directly to the recipient. Notes 7 AAC 48.590 Eff. 7/1/98, Register 147; am 11/27/98, Register 148; am 2/1/2010, Register 193 Authority:AS 47.05.010 AS…

Notes 7 AAC 48.598 Eff. 11/27/98, Register 148; repealed 11/1/2002, Register 164 State regulations are updated quarterly; we currently have two versions available. Below is a comparison between our most recent version and the prior quarterly release. More comparison features will…

In this chapter, (1) "CAMA" means chronic and acute medical assistance; (2) "correctional facility" has the meaning given in AS 11.81.900; (3) "department" means the Department of Health and Social Services; (4) "disability" means being unable to or the inability to engage in sub…

(a) (a) Except as expressly stated in this chapter, hearings for recipients of financial, food, or medical assistance granted by the department in the following programs are conducted under AS 44.64.060 and 2 AAC 64.100 - 2 AAC 64.990: (1) General Relief Assistance (GRA); (2) Gen…

An opportunity for a hearing must be granted to a recipient whose (1) request for financial, food, or medical assistance is denied or is not acted upon with reasonable promptness; or (2) financial, food, or other medical assistance benefits are suspended, terminated, or reduced. …

(a) Unless otherwise provided in federal law, a request for a hearing within the scope of 7 AAC 49.020 must be made to the department in writing by a recipient, or by a legal representative acting on the recipient's behalf, not later than 30 days after the date of the notice requ…

Notes 7 AAC 49.040 Eff. 3/23/78, Register 65; am 6/26/99, Register 150; repealed 4/4/2013, Register 206 State regulations are updated quarterly; we currently have two versions available. Below is a comparison between our most recent version and the prior quarterly release. More c…

Notes 7 AAC 49.050 Eff. 3/23/78, Register 65; am 6/26/99, Register 150; repealed 4/4/2013, Register 206 State regulations are updated quarterly; we currently have two versions available. Below is a comparison between our most recent version and the prior quarterly release. More c…

The department will give written notice to the recipient not later than 10 days before the date the department intends to take action denying, reducing, suspending, or terminating assistance, unless (1) factual evidence exists of the death of the recipient; (2) a recipient indica…

In a written notice provided under 7 AAC 49.060 of a department action to deny, reduce, suspend, or terminate assistance, and unless otherwise specified in applicable federal regulations, the department will state in the written notice the reasons for the proposed action, includi…

Not later than 10 days after the department receives a hearing request, the department will either (1) deny the request in writing for reasons allowed by law, stating the reasons as required under AS 44.64.060(b) and 2 AAC 64.130, and forward notice of that denial to the party wh…

The administrative law judge may consolidate a series of individual requests for hearing by conducting a single group hearing if the sole issue involved is one of state or federal law or policy, or changes in state or federal law or policy. A consolidation of requests does not af…

The administrative law judge shall deny or dismiss a hearing request or terminate a hearing if (1) the issues by which the recipient is aggrieved are not those set out in 7 AAC 49.020; (2) the recipient withdraws the request in writing or orally on the record; (3) the sole issue …

Notes 7 AAC 49.110 Eff. 3/23/78, Register 65; am 6/26/99, Register 150; repealed 4/4/2013, Register 206 State regulations are updated quarterly; we currently have two versions available. Below is a comparison between our most recent version and the prior quarterly release. More c…

(a) After granting a request for a hearing under 7 AAC 49.080, the department will provide the recipient and the administrative law judge with a position statement. In the position statement the department will include a(1) summary of the proposed action and the reasons for the p…

During a hearing under this chapter, (1) the recipient has the right to self-representation, representation by an attorney, or the assistance of an agent under a power of attorney, a guardian, a family member, a friend, or another person who may be helpful in the presentation of …

Notes 7 AAC 49.130 Eff. 3/23/78, Register 65; repealed 6/26/99, Register 150 State regulations are updated quarterly; we currently have two versions available. Below is a comparison between our most recent version and the prior quarterly release. More comparison features will be …

For actions involving termination or reduction of benefits, the burden of proving evidence supporting the termination or reduction is on the department and is by a preponderance of evidence, unless otherwise provided by law. For a request for new or additional benefits, the burde…

In hearings brought under AS 47.07 or 7 AAC 105 - 7 AAC 160, if an administrative law judge finds that a medical assessment is necessary, the administrative law judge may order the assessment at department expense as provided in 42 C.F.R. 431.240(b). Payment at department expense…

(a) For hearings under this chapter, the hearing authority is with the administrative law judge (1) that the office of administrative hearings (AS 44.64.010) assigns to the matter, subject to 2 AAC 64.170; and (2) who conducts the hearing on behalf of the commissioner. (b) The ad…

Notes 7 AAC 49.160 Eff. 3/23/78, Register 65; am 6/26/99, Register 150; repealed 4/4/2013, Register 206 State regulations are updated quarterly; we currently have two versions available. Below is a comparison between our most recent version and the prior quarterly release. More c…

Unless the applicant or recipient has requested a de novo review under the Medicaid program, or if otherwise specified under applicable federal regulations, the scope of the administrative law judge's review is limited to ascertaining whether (1) the laws and policies have been p…

Except as otherwise specified in applicable federal regulations, and unless the period is extended by mutual agreement of the recipient and the department and approved by the assigned administrative law judge, the administrative law judge shall issue the proposed decision require…

Except as otherwise specified in applicable federal regulations, a recipient of assistance other than General Relief, General Relief Medical, or Chronic and Acute Medical assistance that continues to satisfy all eligibility criteria other than those at issue in the hearing reques…

If a request for a hearing has caused a recipient's assistance to be reinstated or continued pending the hearing under 7 AAC 49.190, and if the final decision is that the department action at issue was correct, the administrative law judge may order the recipient to repay the ass…

If the final decision is that the department action at issue was in error, the department will provide assistance retroactive to the effective date of the erroneous denial, suspension, termination, or reduction. Notes 7 AAC 49.210 Eff. 3/23/78, Register 65; am 6/26/99, Register 1…

Notes 7 AAC 49.220 Eff. 3/23/78, Register 65; am 6/26/99, Register 150; repealed 4/4/2013, Register 206 State regulations are updated quarterly; we currently have two versions available. Below is a comparison between our most recent version and the prior quarterly release. More c…

Notes 7 AAC 49.230 Eff. 3/23/78, Register 65; am 6/26/99, Register 150; repealed 4/4/2013, Register 206 State regulations are updated quarterly; we currently have two versions available. Below is a comparison between our most recent version and the prior quarterly release. More c…

Subject to state and federal statutes and regulations safeguarding public assistance information, hearing decisions of the department are public information. Notes 7 AAC 49.240 Eff. 3/23/78, Register 65; am 6/26/99, Register 150; am 4/4/2013, Register 206 Authority:AS 47.05.010 A…