HB 270: "An Act amending the eligibility threshold for medical assistance for persons in a medical or intermediate care facility."
00 HOUSE BILL NO. 270 01 "An Act amending the eligibility threshold for medical assistance for persons in a 02 medical or intermediate care facility." 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 16 income benefit rate under 42 U.S.C. 1381 - 1383c (Title XVI, Social Security Act) 17 [$1,656 A MONTH] but who would not be eligible for an optional state 18 supplementary payment if they left the 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 they 26 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 175 percent of the federal 06 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 175 percent of the federal poverty line as 10 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).