7 AAC 100.068 - Living in a public institution

Current through December 2, 2021

(a) Except as provided in this section, the department will not reimburse Medicaid services provided to a Medicaid-eligible individual while the individual resides in a public institution, regardless of whether placement was voluntary or involuntary, unless the individual is
(1) living in a public institution solely to receive educational or vocational training;
(2) placed in a public institution on a short-term emergency basis pending placement in a living arrangement appropriate to the individual's needs;
(3) living in a correctional facility or juvenile facility but received medical care while an inpatient in a medical institution for at least 24 hours; or
(4) living in a substance abuse treatment facility or a halfway house that has a contract with the state to provide treatment and monitoring.
(b) The following individuals living in a public institution may become Medicaid-eligible while residing in, or retain their existing eligibility upon entry into, the public institution, if all applicable Medicaid eligibility requirements are met:
(1) a prisoner who is in a correctional facility under AS 33.30;
(2) a delinquent minor who is in the custody of the department under AS 47.12.120(b)(l) or 47.12.240.
(c) In this section,
(1) "correctional facility" has the meaning given in AS 33.30.901;
(2) "delinquent minor" has the meaning given in AS 47.12.990;
(3) "juvenile facility" has the meaning given in 7 AAC 52.900;
(4) "prisoner"
(A) has the meaning given in AS 33.30.901;
(B) includes an individual who
(i) is on temporary furlough; or
(ii) has temporarily left a correctional facility or public institution for treatment in an acute care medical facility;
(5) "public institution"
(A) means an institution, including a correctional facility or juvenile detention facility, that is the responsibility of a governmental unit or over which a governmental unit exercises administrative control;
(B) does not include a medical institution.


7 AAC 100.068
Eff. 7/20/2007, Register 183; am 1/1/2011, Register 196; am 9/20/2015, Register 215, October 2015

Authority:AS 47.05.010

AS 47.07.020

AS 47.07.040

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