SB 168: "An Act relating to Medicaid coverage, including coverage for children and pregnant women; and providing for an effective date."
00SENATE BILL NO. 168 01 "An Act relating to Medicaid coverage, including coverage for children and 02 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), as amended by secs. 38 - 42, ch. 107, SLA 1996, is 05 amended to read: 06 (b) In addition to the persons specified in (a) of this section, the following 07 optional groups of persons for whom the state may claim federal financial participation 08 are eligible for medical assistance: 09 (1) persons eligible for but not receiving assistance under any plan of 10 the state approved under 42 U.S.C. 1381 - 1383c (Title XVI, Social Security Act, 11 Supplemental Security Income) or a federal program designated as the successor to the 12 aid to families with dependent children program; 13 (2) persons in a general hospital, skilled nursing facility, or intermediate 14 care facility, who, if they left the facility, would be eligible for assistance under one
01 of the federal programs specified in (1) of this subsection; 02 (3) persons under age 21 who are under supervision of the department, 03 for whom maintenance is being paid in whole or in part from public funds, and who 04 are in foster homes or private child-care institutions; 05 (4) aged, blind, or disabled persons, who, because they do not meet 06 income and resources requirements, do not receive supplemental security income under 07 42 U.S.C. 1381 - 1383c (Title XVI, Social Security Act), and who do not receive a 08 mandatory state supplement, but who are eligible, or would be eligible if they were not 09 in a skilled nursing facility or intermediate care facility to receive an optional state 10 supplementary payment; 11 (5) persons under age 21 who are in an institution designated as an 12 intermediate care facility for the mentally retarded and who are financially eligible as 13 determined by the standards of the federal program designated as the successor to the 14 aid to families with dependent children program; 15 (6) persons in a medical or intermediate care facility whose income 16 while in the facility does not exceed 300 percent of the supplemental security income 17 benefit rate under 42 U.S.C. 1381 - 1383c (Title XVI, Social Security Act) but who 18 would not be eligible for an optional state supplementary payment if they left the 19 hospital or other facility; 20 (7) persons under age 21 who are receiving active treatment in a 21 psychiatric hospital and who are financially eligible as determined by the standards of 22 the federal program designated as the successor to the aid to families with dependent 23 children program; 24 (8) persons under age 21 and not covered under (a) of this section, who 25 would be eligible for benefits under the federal program designated as the successor 26 to the aid to families with dependent children program, except that they have the care 27 and support of both their natural and adoptive parents; 28 (9) persons under age 18 not covered under (a) of this section 29 whose household income does not exceed 225 percent of the federal poverty line 30 as defined by the federal office of management and budget and revised annually 31 under 42 U.S.C. 9902(2);
01 (10) pregnant women not covered under (a) of this section whose 02 household income does not exceed 200 percent of the federal poverty line as 03 defined by the federal office of management and budget and revised annually 04 under 42 U.S.C. 9902(2); 05 (11) pregnant women not covered under (a) of this section and who 06 meet the income and resource requirements of the federal program designated as the 07 successor to the aid to families with dependent children program; 08 (12) [(10)] persons under age 21 not covered under (a) of this section 09 who the department has determined cannot be placed for adoption without medical 10 assistance because of a special need for medical or rehabilitative care and who the 11 department has determined are hard-to-place children eligible for subsidy under 12 AS 25.23.190 - 25.23.220; 13 (13) [(11)] persons who can be considered under 42 U.S.C. 1396a(e)(3) 14 (Title XIX, Social Security Act, Medical Assistance) to be individuals with respect to 15 whom a supplemental security income is being paid under 42 U.S.C. 1381 - 1383c 16 (Title XVI, Social Security Act) because they meet all of the following criteria: 17 (A) they are 18 years of age or younger and qualify as disabled 18 individuals under 42 U.S.C. 1382c(a) (Title XVI, Social Security Act); 19 (B) the department has determined that 20 (i) they require a level of care provided in a hospital, 21 nursing facility, or intermediate care facility for the mentally retarded; 22 (ii) it is appropriate to provide their care outside of an 23 institution; and 24 (iii) the estimated amount that would be spent for 25 medical assistance for their individual care outside an institution is not 26 greater than the estimated amount that would otherwise be expended 27 individually for medical assistance within an appropriate institution; 28 (C) if they were in a medical institution, they would be eligible 29 for medical assistance under other provisions of this chapter; and 30 (D) home and community-based services under a waiver 31 approved by the federal government are either not available to them under this
01 chapter or would be inappropriate for them. 02 * Sec. 2. AS 47.07.035, as amended by sec. 43, ch. 107, SLA 1996, is amended to read: 03 Sec. 47.07.035. Priority of medical assistance. If the department finds that 04 the cost of medical assistance for all persons eligible under this chapter will exceed 05 the amount allocated in the state budget for that assistance for the fiscal year, the 06 department shall eliminate coverage for optional medical services and optionally 07 eligible groups of individuals in the following order: 08 (1) midwife services; 09 (2) clinical social workers' services; 10 (3) psychologists' services; 11 (4) chiropractic services; 12 (5) advanced nurse practitioner services; 13 (6) adult dental services; 14 (7) emergency hospital services; 15 (8) treatment of speech, hearing, and language disorders; 16 (9) optometrists' services and eyeglasses; 17 (10) occupational therapy; 18 (11) mammography screening; 19 (12) prosthetic devices; 20 (13) medical supplies and equipment; 21 (14) targeted case management services; 22 (15) rehabilitative services for substance abusers and emotionally 23 disturbed or chronically mentally ill adults; 24 (16) clinic services; 25 (17) physical therapy; 26 (18) personal care services in a recipient's home; 27 (19) prescribed drugs; 28 (20) hospice care; 29 (21) long-term care noninstitutional services; 30 (22) inpatient psychiatric facility services; 31 (23) intermediate care facility services for the mentally retarded;
01 (24) intermediate care facility services; 02 (25) individuals described in AS 47.07.020(b)(13) 03 [AS 47.07.020(b)(11)]; 04 (26) individuals under age 21 who are not eligible for benefits under 05 the federal program designated as the successor to the aid to families with dependent 06 children program because they are not deprived of one or more of their natural or 07 adoptive parents; 08 (27) skilled nursing facility services for persons under age 21; 09 (28) aged, blind, and disabled individuals who, because they do not 10 meet the income requirements, do not receive supplemental security income under Title 11 XVI of the Social Security Act, but who are eligible, or would be eligible if they were 12 not in a skilled nursing facility or intermediate care facility, to receive an optional state 13 supplementary payment; 14 (29) individuals in a hospital, skilled nursing facility, or intermediate 15 care facility whose income while in the facility does not exceed 300 percent of the 16 supplemental security income benefit rate under Title XVI of the Social Security Act, 17 but who, because of income, are not eligible for the optional state supplementary 18 payment; 19 (30) individuals under age 21 under supervision of the department for 20 whom maintenance is being paid in whole or in part from public money and who are 21 in foster homes or private child-care institutions; 22 (31) individuals under age 21 who the department has determined 23 cannot be placed for adoption without medical assistance because of a special need for 24 medical or rehabilitative care and who the department has determined are hard-to-place 25 children eligible for subsidy under AS 25.23.190 - 25.23.220; 26 (32) persons under age 18 not covered under AS 47.07.020(a) whose 27 household income does not exceed 225 percent of the federal poverty line as 28 defined by the federal office of management and budget and revised annually 29 under 42 U.S.C. 9902(2); 30 (33) pregnant women not covered under AS 47.07.020(a) whose 31 household income does not exceed 200 percent of the federal poverty line as
01 defined by the federal office of management and budget and revised annually 02 under 42 U.S.C. 9902(2). 03 * Sec. 3. This Act takes effect July 1, 1997.