Title 47 — Welfare, Social Services, and Institutions

It is the public policy of the state to cooperate and coordinate with the United States government and its agencies in providing for and administering federal and state laws for adult public assistance and the other assistance that is provided for or extended to the people of the…

In AS 47.06.010 — 47.06.100, unless the context otherwise requires, “department” means Department of Family and Community Services.

It is declared by the legislature as a matter of public concern that the needy persons of this state who are eligible for medical care at public expense under this chapter should seek only uniform and high quality care that is appropriate to their condition and cost-effective to …

(a) All residents of the state for whom the Social Security Act requires Medicaid coverage are eligible to receive medical assistance under 42 U.S.C. 1396 — 1396p (Title XIX, Social Security Act). (b) In addition to the persons specified in (a) of this section, the following opti…

(a) An applicant for or recipient of assistance under this chapter is considered to have assigned to the state, through the department and the child support services agency, all rights to accrued and continuing medical support that the applicant and other persons for whom assista…

(a) The department shall offer all mandatory services required under 42 U.S.C. 1396 — 1396p (Title XIX of the Social Security Act). (b) In addition to the mandatory services specified in (a) of this section and the services provided under (d) of this section, the department may o…

(a) Notwithstanding AS 47.07.030, the department may not grant assistance under this chapter for inpatient psychiatric services to a person under 21 years of age who is in an out-of-state psychiatric hospital facility or an out-of-state residential psychiatric treatment center un…

[Repealed or reserved.]

(a) If the department finds that the costs of medical assistance for all persons eligible under this chapter will exceed the amount allocated in the state budget for a fiscal year, the department may implement cost containment measures to reduce anticipated program costs for that…

[Repealed or reserved.]

(a) The department shall contract with one or more third parties to implement one or more coordinated care demonstration projects for recipients of medical assistance identified by the department. The purpose of a demonstration project under this section is to assess the efficacy…

The department shall prepare a state plan in accordance with the provisions of 42 U.S.C. 1396 — 1396p (Title XIX, Social Security Act, Medical Assistance) and submit it for approval to the United States Department of Health and Human Services. The plan shall designate that the De…

(a) Except as provided in (b) — (d) of this section, the state plan developed under AS 47.07.040 shall impose deductible, coinsurance, and copayment requirements on persons eligible for assistance under this chapter to the maximum extent allowed under federal law and regulations.…

(a) The department may provide home and community-based services under a waiver in accordance with 42 U.S.C. 1396 — 1396p (Title XIX, Social Security Act), this chapter, and regulations adopted under this chapter, if the department has received approval from the federal governmen…

(a) The department shall provide traumatic or acquired brain injury services under a waiver in accordance with 42 U.S.C. 1396 — 1396p (Title XIX, Social Security Act), this chapter, and regulations adopted under this chapter, if the department has received approval from the feder…

[Repealed or reserved.]

The department shall take the steps necessary to adopt those regulations, prepare necessary documentation for the state and providers, and undertake the systems design that may be necessary to implement the provisions of this chapter on or before November 1, 1972. Implementation …

(a) The estate of an individual who received medical assistance payments is subject to a claim for recovery of the medical assistance after the individual's death that, except as provided in (b) of this section, may be secured by a lien filed against the individual's real propert…

The Department of Administration shall accept and receive all grants of money awarded to the state under 42 U.S.C. 1396 — 1396p (Title XIX, Social Security Act, Medical Assistance). All money received shall be deposited by the Department of Administration in a special account of …

(a) The department may pay medical assistance under this chapter to a school district on behalf of an eligible child, including a child with a disability, for rehabilitative and other mandatory and optional services covered under this chapter that are furnished or paid for by the…

(a) The department shall pay for prescribed drugs under AS 47.07.030(b) under regulations adopted by the commissioner in conformity with applicable federal regulations. (b) The department shall adopt in regulation and regularly update a preferred drug list and a prior authorizati…

(a) Subject to appropriation, the department shall pay for minimum treatment and for preventative and restorative adult dental services provided under AS 47.07.030(b) and under regulations adopted by the commissioner in conformity with applicable federal requirements and this cha…

(a) The department may not pay for abortion services under this chapter unless the abortion services are for a medically necessary abortion or the pregnancy was the result of rape or incest. Payment may not be made for an elective abortion. (b) In this section, (1) “abortion” has…

(a) [See conditional amendment note.] The department shall pay for all services covered by the medical assistance program provided through telehealth in the same manner as if the services had been provided in person, including (1) behavioral health services; (2) services covered …

(a) The department shall, by regulation, set rates of payment for health facilities under this chapter and AS 47.25.120 — 47.25.300 in accordance with 42 U.S.C. 1396 (Title XIX, Social Security Act, Medical Assistance) and this section. A rate established under this section takes…

After the end of each fiscal year of a health facility, the facility shall submit to the department a report on the facility's financial performance during the fiscal year. The commissioner shall, by regulation, establish the date by which this financial report is due.

[Repealed or reserved.]

(a) The department by regulation shall require a uniform system of accounting, budgeting, and reporting for health facilities receiving payments under this chapter. The regulations must provide for reporting revenues, expenses, assets, liabilities, units of service, and other ite…

(a) As a condition of obtaining payment under AS 47.07.070, a health facility shall allow (1) the department reasonable access to the records of medical assistance recipients and providers; and (2) audit and inspection of the records by state and federal agencies. (b) The departm…

(a) Actions of the department regarding health facility payment rates under this chapter and AS 47.25.120 — 47.25.300 are subject to provisions of AS 44.62 (Administrative Procedure Act) except as provided in (b) of this section, and the hearing for an appeal must be conducted by…

(a) The department and the attorney general shall annually prepare a report relating to the medical assistance program under this chapter. The report must include the following information: (1) the amount and source of funds used to prevent or prosecute fraud, abuse, payment erro…

[Repealed or reserved.]

(a) The department shall develop a program to provide supplemental reimbursement to eligible emergency medical transportation service providers for the cost of providing services to medical assistance recipients. Except as provided in (b) of this section, the amount of the supple…

[Repealed or reserved.]

In this chapter, (1) [Repealed, § 4 ch 52 SLA 2006.] (2) “advanced practice registered nurse services” means services furnished by a person who is licensed as an advanced practice registered nurse under AS 08.68.850 that are within the scope of regulations adopted under AS 08.68.…

(a) Subject to (b) of this section, under AS 47.08.010 — 47.08.140, the Department of Health may reimburse providers of medical care for unpaid costs incurred in the treatment of a person suffering an illness or accident that results in financial catastrophe to the person or the …

There is created the Catastrophic Illness Committee, consisting of a medical review officer from the Department of Health, a member appointed by the governor who has suffered a catastrophic illness, and a representative of the Department of Commerce, Community, and Economic Devel…

The committee shall enlist the assistance of medical providers in making the public aware of the catastrophic illness assistance program.

An application for financial assistance under AS 47.08.010 — 47.08.140 may be filed by a person who has suffered catastrophic illness or by a parent, spouse, or legal guardian of that person, or by any other interested party with the written consent of the person who has suffered…

Annually, the committee shall determine in light of appropriated funds and expected need the medical expenses reimbursable under AS 47.08.010 — 47.08.140, except that the following are not reimbursable: (1) dentistry and optometry unless prescribed by a licensed dentist or physic…

(a) As frequently as necessary the committee shall adopt, in light of appropriated funds and expected need, a formula to be used in determining the applicant's share of total medical expenses incurred as a result of a catastrophic illness, based on the applicant's annual gross in…

The amount that the committee reimburses providers for medical services rendered to a person who has suffered catastrophic illness may not be greater than 100 percent of the total unpaid bills related to the catastrophic illness and shall be determined by the following standards:…

The committee shall promptly notify an applicant of its decision with written reasons for the amount of the award or denial. An applicant who is dissatisfied with a decision of the committee may apply to the committee for reconsideration within 30 days of receipt of the decision.…

An applicant who is dissatisfied with the committee's decision upon reconsideration may request a hearing in accordance with procedures established under AS 47.25.180.

Decisions as to catastrophic illness awards are final (1) 30 days after the applicant receives the committee's decision unless a reconsideration is requested during that time; (2) 30 days after the applicant receives the committee's decision upon reconsideration unless a hearing …

Time limits for reconsideration or for requesting an appeal may be extended, at the discretion of the committee, upon application or upon the committee's own motion. A request for reconsideration or for a hearing shall be considered made on the date when the request is dispatched…

If the applicant or a provider receives payment from any other source for medical expenses that have been paid by the committee, the applicant or provider is liable to the committee in the amount of that payment. An application may not be considered by the committee unless the ap…

The department may adopt regulations, under AS 44.62 (Administrative Procedure Act) that establish rates of reimbursement to providers for medical expenses incurred, as well as other regulations necessary to carry out the purposes of AS 47.08.010 — 47.08.140.

Article 2. Assistance for Chronic or Acute Medical Conditions. In AS 47.08.010 — 47.08.140, (1) “applicant” means a person who has suffered a catastrophic illness and is applying for assistance under AS 47.08.010 — 47.08.140 or is the subject of an application for assistance unde…

(a) Under the provisions of this section, the Department of Health may pay providers of medical care for services described in (c) of this section that are provided to needy persons suffering from a chronic or acute medical condition who may apply for assistance under (b) of this…