7 AAC 100.990 - Definitions
In this chapter, unless the context requires otherwise,
(1) "AB" means aid to the
blind under former 42 U.S.C.
1201 (Title X of the Social Security
Act);
(2) "adoption" means the
establishment of a parent-child relationship between a child and an adult who
is not the child's birth parent and that is recognized by law, including an
adoption established by order of a state court, an adoption established by
order of a tribal court with respect to an "Indian child" within the meaning
given in 25 U.S.C.
1903 (Indian Child Welfare Act), and an
adoption under tribal custom;
(3)
"adoptive" means a relationship that exists as a result of an
adoption;
(4) "Adult Public
Assistance" means the program under
AS
47.25.430-47.25.615 that provides monthly
cash assistance to eligible aged, blind, and disabled persons in need; for
purposes of this chapter, "Adult Public Assistance" does not include interim
assistance under
AS
47.25.455;
(5) "advanced nurse practitioner" means an
individual
(A) licensed under AS 08.68 as an
advanced nurse practitioner; or
(B)
who is authorized by federal law to practice as an advanced nurse practitioner
without a license issued under AS 08.68, including federal employees and
individuals working under contract with the United States;
(6) "APA" means the Adult Public Assistance
program;
(7) "applicant" means an
individual who has submitted an identifiable application in accordance with
7 AAC 100.004 and whose eligibility for Medicaid has not
been approved or denied; "applicant" includes
(A) a parent or legal guardian who submits an
application on behalf of a minor child in the custody of that parent or legal
guardian; and
(B) an individual,
alive or deceased, who is not a minor and whose application is submitted
through an authorized representative or a person acting responsibly for the
individual;
(8) "APTD"
means aid to the permanently and totally disabled under former
42 U.S.C.
1351 (Title XIV of the Social Security
Act);
(9) "assisted living home"
has the meaning given in
AS
47.33.990;
(10) "business property" means property used
to operate a business or generate income;
(11) "caretaker relative"
(A) means any of the following individuals
who, for purposes of the eligibility categories in
7 AAC 100.002(a) and (c), provide the
care and control of a dependent child:
(i) a
biological or legally adoptive relative of the dependent child to the fifth
degree of consanguinity; a biological relative must be of full or half blood; a
biological relative may be a caretaker relative even though the legal
relationship has been terminated;
(ii) a stepfather, stepmother, stepbrother,
or stepsister of the dependent child;
(iii) the spouse of an individual described
in (i) or (ii) of this subparagraph, even after the marriage is terminated by
death or divorce; and
(B) does not include
(i) a legal guardian;
(ii) a friend or neighbor;
(iii) an unrelated godparent;
(iv) a second cousin of a dependent child;
or
(v) an individual who has been
given a dependent child to take care of;
(12) "child support services agency" means
the child support services agency of the Department of Revenue;
(13) "commissioner" means the commissioner of
health and social services;
(14)
"community spouse" means an individual who
(A)
is living outside of a long-term care facility;
(B) is not receiving home and community-based
waiver services; and
(C) is the
spouse of an applicant or recipient who is living in a long-term care facility
or receiving home and community-based waiver services;
(15) "continuous period of
institutionalization" means at least 30 consecutive days of residing in a
medical institution or receiving home and community-based waiver
services;
(16) "countable resource"
means a nonexcluded and nonexempt resource of a household that is included in
the total of a household's resources for purposes of determining if the
household has resources at or below the resource limit for the applicable
eligibility category;
(17)
"department" means the Department of Health and Social Services;
(18) "dependent" means an individual who
derives the individual's main support from another individual;
(19) "district office" means the office of
the department that is responsible for determining Medicaid eligibility under
this chapter;
(21) "fee agent" means a department-paid
volunteer who is authorized by the department to conduct a face-to-face
interview with an applicant or recipient and assist an applicant or recipient
in completing an application and related forms;
(22) "home and community-based waiver
services" means services provided under
AS
47.07.045 and 7 AAC 130;
(23) "household" means those individuals
whose financial need, income, and resources are used to determine Medicaid
eligibility under this chapter;
(24) "inpatient" means an individual who has
been admitted to a medical institution as an inpatient by a physician or
dentist and who
(A) receives room, board, and
professional services in the institution for a 24-hour period or longer;
or
(B) is expected by the medical
institution to receive room, board, and professional services in the
institution for a 24-hour period or longer even if the individual
(i) dies, is discharged, or is transferred to
another facility; and
(ii) does not
actually stay in the medical institution for 24 hours;
(25) "intermediate care facility
for the mentally retarded" means a facility described in
7 AAC 12.300;
(26) "long-term care facility" means an
establishment that is
(A) regulated by the
department under AS 18.20 as a skilled nursing facility or intermediate care
facility; or
(B) owned or operated
as a skilled nursing facility or intermediate care facility by the United
States, an Indian tribe, or a tribal organization and exempt from state
licensure under applicable law;
(27) "long-term care services" means
(A) services provided in a long-term care
facility;
(B) services provided in
an intermediate care facility for the mentally retarded;
(C) home and community-based waiver services;
and
(D) any other services received
in a medical institution by a recipient who is an institutionalized individual
required to pay a portion of that individual's income toward the cost of care
under 7 AAC 100.550 -
7 AAC 100.579;
(28) "mandatory state supplement" means the
payment made by a state that supplements the federal payment made to recipients
of the APTD program and that was made a mandatory payment under P.L.
93-66;
(29) "Medicaid" means the
medical assistance program administered by the department under
42 U.S.C.
1396 -
1396 v and AS 47.07;
(30) "medical institution"
(A) means a facility that provides medical
care, including nursing and convalescent care, and that is
(i) licensed or certified by the department
to provide that care; or
(ii) owned
or operated by the United States, an Indian tribe, or a tribal organization and
exempt from state licensure or certification under applicable law;
and
(B) includes a
hospital, skilled nursing facility, intermediate care facility, intermediate
care facility for the mentally retarded, residential psychiatric treatment
center, and assisted living home that provides residential supported living and
habilitation services;
(31) "Medicare" means the medical assistance
program administered by the federal government through private insurance
companies under 42 U.S.C.
1395 -
1395 hhh;
(32) "Medicare Part A" means that portion of
the Medicare program providing coverage for hospital care under
42 U.S.C.
1395 c - 1395i-5;
(33) "Medicare Part B" means that portion of
the Medicare program providing coverage for physician and outpatient care under
42 U.S.C.
1395 j - 1395w-4;
(34) "mental health professional" has the
meaning given in
AS
47.30.915;
(35) "month" means a calendar month unless
otherwise specified in this chapter;
(36) "motor vehicle" means a motorized
vehicle used to provide transportation of individuals or goods; "motor vehicle"
(A) includes a car, truck, recreational
vehicle, all-terrain vehicle, boat, snowmachine, airplane, helicopter,
superlight or ultralight aircraft, and hovercraft; and
(B) does not include a pickup truck shell or
camper that is designed to be mounted on a car or truck;
(37) "newborn" means an infant under one year
of age;
(38) "nonfinancial
eligibility requirement" means an eligibility requirement other than one
relating to income or resources;
(39) "OAA" means old age assistance under
former 42 U.S.C.
301 (Title I of the Social Security
Act);
(40) "OASDI" means old age,
survivors, and disability insurance under
42 U.S.C.
401 -
434 (Title II of the Social
Security Act);
(41) "parent" means
a child's natural or adoptive father or mother;
(42) "physician" means an individual
(A) licensed as a physician under AS 08.64;
or
(B) who is authorized by federal
law to practice as a physician without a license issued under AS 08.64,
including federal employees and individuals working under contract with the
United States;
(43)
"physician assistant" means an individual
(A)
licensed as a physician assistant under AS 08.64; or
(B) who is authorized by federal law to
practice as a physician assistant without a license issued under AS 08.64,
including federal employees and individuals working under contract with the
United States;
(44)
"psychiatric hospital" means
(A) a hospital
described in
7 AAC 12.215(a); or
(B) a similar hospital that is
(i) owned or operated by the United States,
an Indian tribe, or a tribal organization; and
(ii) exempt from state licensure under
applicable law;
(45) "recipient" means an individual who has
been found eligible to receive, and is receiving Medicaid benefits;
(46) "resource" means cash, or an asset that
can be converted to cash; "resource" includes
(A) real estate;
(B) cash on hand; cash on deposit; and other
liquid resources such as a promissory note, stock, bond, or security that is
readily convertible to cash;
(C) a
life insurance policy, burial insurance policy, or a prepaid burial
contract;
(D) a United States
government savings bond or treasury note; a municipal or government bond; or a
corporate bond, stock, or security;
(E) the portion of a lump-sum payment
received by the applicant or recipient that is treated as a resource rather
than income under this chapter; a lump-sum payment includes a large termination
paycheck, insurance policy cash-in, and inheritance;
(F) a motor vehicle; and
(G) all household goods and personal
effects;
(47) "sibling"
means a brother or sister related by blood or adoption; "sibling" includes a
half-sibling; "sibling" does not include a step-sibling;
(48) "sponsor" means a person who agrees in
writing to support an alien as a condition of the alien's entry into the United
States; "sponsor" does not include an alien's parent or spouse;
(49) "SSDI" means social security disability
insurance under 42 U.S.C.
423 (sec. 223 of the Social Security
Act);
(51) "stepparent" means an individual who is
not a child's natural or adoptive parent, but who is legally married to a
natural or adoptive parent of the child;
(54) "tribal organization" has the meaning
given in 25 U.S.C.
450 b (l);
(55) "TRICARE" means the United States
Department of Defense regionally managed health care program for active duty
and retired members of the uniformed services, their families, and
survivors;
(56) "USCIS" means the
United States Department of Homeland Security, United States Citizenship and
Immigration Services;
(57) "Indian
tribe" means a tribe recognized by the United States Secretary of Interior to
exist as an Indian tribe under
25 U.S.C.
479 a (Federally Recognized Indian Tribe List
Act of 1994).
(58) "dentist" means
an individual
(A) licensed as a dentist under
AS 08.36; or
(B) who is authorized
by federal law to practice as a dentist without a license issued under AS
08.36, including federal employees and individuals working under contract with
the United States.
Notes
Authority:AS 47.05.010
AS 47.07.020
AS 47.07.040
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