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SB 5: "An Act relating to eligibility requirements for medical assistance for certain children and pregnant women; and providing for an effective date."

00                              SENATE BILL NO. 5                                                                          
01 "An Act relating to eligibility requirements for medical assistance for certain children                                
02 and pregnant women; and providing for an effective date."                                                               
03 BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF ALASKA:                                                                
04    * Section 1. AS 47.07.020(b) is amended to read:                                                                   
05            (b)  In addition to the persons specified in (a) of this section, the following                              
06       optional groups of persons for whom the state may claim federal financial                                         
07       participation are eligible for medical assistance:                                                                
08                 (1)  persons eligible for but not receiving assistance under any plan of                                
09       the state approved under 42 U.S.C. 1381 - 1383c (Title XVI, Social Security Act,                                  
10       Supplemental Security Income) or a federal program designated as the successor to the                             
11       aid to families with dependent children program;                                                                  
12                 (2)  persons in a general hospital, skilled nursing facility, or                                        
13       intermediate care facility, who, if they left the facility, would be eligible for assistance                      
14       under one of the federal programs specified in (1) of this subsection;                                            
01                 (3)  persons under 21 years of age who are under supervision of the                                     
02       department, for whom maintenance is being paid in whole or in part from public                                    
03       funds, and who are in foster homes or private child-care institutions;                                            
04                 (4)  aged, blind, or disabled persons, who, because they do not meet                                    
05       income and resources requirements, do not receive supplemental security income                                    
06       under 42 U.S.C. 1381 - 1383c (Title XVI, Social Security Act), and who do not                                     
07       receive a mandatory state supplement, but who are eligible, or would be eligible if                               
08       they were not in a skilled nursing facility or intermediate care facility to receive an                           
09       optional state supplementary payment;                                                                             
10                 (5)  persons under 21 years of age who are in an institution designated                                 
11       as an intermediate care facility for the mentally retarded and who are financially                                
12       eligible as determined by the standards of the federal program designated as the                                  
13       successor to the aid to families with dependent children program;                                                 
14                 (6)  persons in a medical or intermediate care facility whose income                                    
15       while in the facility does not exceed 300 percent of the supplemental security income                             
16       benefit rate under 42 U.S.C. 1381 - 1383c (Title XVI, Social Security Act) but who                                
17       would not be eligible for an optional state supplementary payment if they left the                                
18       hospital or other facility;                                                                                       
19                 (7)  persons under 21 years of age who are receiving active treatment in                                
20       a psychiatric hospital and who are financially eligible as determined by the standards                            
21       of the federal program designated as the successor to the aid to families with                                    
22       dependent children program;                                                                                       
23                 (8)  persons under 21 years of age and not covered under (a) of this                                    
24       section [,] who would be eligible for benefits under the federal program designated as                            
25       the successor to the aid to families with dependent children program [,] except that                              
26       they have the care and support of both their natural and adoptive parents;                                        
27                 (9)  pregnant women not covered under (a) of this section and who                                       
28       meet the income and resource requirements of the federal program designated as the                                
29       successor to the aid to families with dependent children program;                                                 
30                 (10)  persons under 21 years of age not covered under (a) of this section                               
31       who the department has determined cannot be placed for adoption without medical                                   
01       assistance because of a special need for medical or rehabilitative care and who the                               
02       department has determined are hard-to-place children eligible for subsidy under                                   
03       AS 25.23.190 - 25.23.210;                                                                                         
04                 (11)  persons who can be considered under 42 U.S.C. 1396a(e)(3) (Title                                  
05       XIX, Social Security Act, Medical Assistance) to be individuals with respect to whom                              
06       a supplemental security income is being paid under 42 U.S.C. 1381 - 1383c (Title                                  
07       XVI, Social Security Act) because they meet all of the following criteria:                                        
08                      (A)  they are 18 years of age or younger and qualify as disabled                                   
09            individuals under 42 U.S.C. 1382c(a) (Title XVI, Social Security Act);                                       
10                      (B)  the department has determined that                                                            
11                           (i)  they require a level of care provided in a hospital,                                     
12                 nursing facility, or intermediate care facility for the mentally retarded;                              
13                           (ii)  it is appropriate to provide their care outside of an                                   
14                 institution; and                                                                                        
15                           (iii)  the estimated amount that would be spent for                                           
16                 medical assistance for their individual care outside an institution is not                              
17                 greater than the estimated amount that would otherwise be expended                                      
18                 individually for medical assistance within an appropriate institution;                                  
19                      (C)  if they were in a medical institution, they would be eligible                                 
20            for medical assistance under other provisions of this chapter; and                                           
21                      (D)  home and community-based services under a waiver                                              
22            approved by the federal government are either not available to them under this                               
23            chapter or would be inappropriate for them;                                                                  
24                 (12)  disabled persons, as described in 42 U.S.C.                                                       
25       1396a(a)(10)(A)(ii)(XIII), who are in families whose income, as determined under                                  
26       applicable federal regulations or guidelines, is less than 250 percent of the official                            
27       poverty line applicable to a family of that size according to the United States                                   
28       Department of Health and Human Services, and who, but for earnings in excess of the                               
29       limit established under 42 U.S.C. 1396d(q)(2)(B), would be considered to be                                       
30       individuals with respect to whom a supplemental security income is being paid under                               
31       42 U.S.C. 1381 - 1383c; a person eligible for assistance under this paragraph who is                              
01       not eligible under another provision of this section shall pay a premium or other cost-                           
02       sharing charges according to a sliding fee scale that is based on income as established                           
03       by the department in regulations;                                                                                 
04                 (13)  persons under 19 years of age who are not covered under (a) of                                    
05       this section and whose household income does not exceed 200 [175] percent of the                              
06       federal poverty line as defined by the United States Department of Health and Human                               
07       Services and revised under 42 U.S.C. 9902(2);                                                                     
08                 (14)  pregnant women who are not covered under (a) of this section and                                  
09       whose household income does not exceed 200 [175] percent of the federal poverty line                          
10       as defined by the United States Department of Health and Human Services and revised                               
11       under 42 U.S.C. 9902(2);                                                                                          
12                 (15)  persons who have been diagnosed with breast or cervical cancer                                    
13       and who are eligible for coverage under 42 U.S.C. 1396a(a)(10)(A)(ii)(XVIII).                                     
14    * Sec. 2. AS 47.07.042(d) is amended to read:                                                                      
15            (d)  In addition to the requirements established under (a) and (b) of this section,                          
16       the department may require premiums or cost-sharing contributions from recipients                                 
17       who are eligible for benefits under AS 47.07.020(b)(13) and whose household income                                
18       is between 150 and 200 [175] percent of the federal poverty line. If the department                           
19       requires premiums or cost-sharing contributions under this subsection, the department                             
20                 (1)  shall adopt in regulation a sliding scale for those premiums or                                    
21       contributions based on household income;                                                                          
22                 (2)  may not exceed the maximums allowed under federal law; and                                         
23                 (3)  shall implement a system by which the department or its designee                                   
24       collects those premiums or contributions.                                                                         
25    * Sec. 3. This Act takes effect immediately under AS 01.10.070(c).