7 AAC 47.370 - Concurrent applications; reimbursement to department by resident or by assisted living home
(a) Not later than 30 days after an
individual applies for assistance under
7
AAC 47.300 - 7 AAC 47.535, the individual must also
submit an application to each agency, organization, or program that provides
financial assistance for which the individual may be eligible. The department,
or a responsible person acting on the individual's behalf, may assist the
individual in submitting each application. If the individual fails to apply for
each program under this subsection, assistance under
7
AAC 47.300 - 7 AAC 47.535 will be denied unless the
department determines that the individual is ineligible for a specified
program. Under this subsection, an individual must apply for each of the
following programs:
(1) Social
Security;
(2) Supplemental Security
Income (SSI);
(3)
Medicaid;
(4) adult public
assistance (APA) under 7 AAC 40; and
(5) the home and community-based waiver
services program under 7 AAC 130.
(b) In addition to the requirements of (a) of
this section, the department may require an individual to apply for other
benefits for which the department believes the individual is eligible,
including veterans' and disability insurance benefits, workers' compensation,
unemployment compensation, retirement system benefits, awards, or annuities.
The department will provide 30 days' written notice to the individual if
additional program applications are required. If the individual fails to apply
for the benefits set out in the written notice, assistance under
7
AAC 47.300 - 7 AAC 47.535 may be denied, If the
individual is a resident of an assisted living home when written notice is
issued under this subsection, the department will provide a copy of the written
notice to the assisted living home. An assisted living home that receives a
notice under this subsection may choose to immediately issue a notice to the
individual under
7
AAC 47.490, advising that the individual may be
subject to involuntary discharge from the home if the individual fails to apply
for benefits as requested by the department.
(c) A resident of an assisted living home,
placed in the home under
7
AAC 47.400, who is later determined eligible for other
assistance applied for as required by (a) and (b) of this section, or whose
total monthly countable income exceeds the minimum daily reimbursement rate set
under 7 AAC 47.470, shall
(1) inform the department of any payments or
benefits for which the resident has been determined eligible; and
(2) forward to the department
(A) any retroactive payments received, up to
the amount the department has provided for that resident under
7
AAC 47.300 - 7 AAC 47.535, if the additional
assistance received is intended to cover any portion of the same care that the
assistance under
7
AAC 47.300 - 7 AAC 47.535 covered for that resident;
and
(B) an amount that reimburses
the department for assistance paid under this chapter for any period that the
resident's total monthly countable income exceeded the minimum daily
reimbursement rate set under
7
AAC 47.470.
(d) If an assisted living home receives a
payment, including a retroactive payment, from another agency, organization, or
program, or from a family member, relative, or other person for providing care
to a resident receiving assistance under
7
AAC 47.300 - 7 AAC 47.535, the administrator shall
reimburse the department up to the amount the department has provided for that
resident under
7
AAC 47.300 - 7 AAC 47.535 if the additional assistance
received is intended to cover any portion of the same care that the assistance
under 7 AAC 47.300 - 7 AAC 47.535 covered
for that resident.
(e) The
department may require an assignment of rights to bill for and receive
reimbursement for assistance provided under
7
AAC 47.300 - 7 AAC 47.535 from
(2) an assisted living home that is entitled
to receive a retroactive payment from another agency, organization, or program
for providing care to a resident receiving assistance under
7
AAC 47.300 - 7 AAC 47.535 for financial assistance
received that is intended to cover any portion of the same care that the
assistance under
7
AAC 47.300 - 7 AAC 47.535 covered for that
resident.
Notes
Authority: AS 47.05.010
AS 47.25.120
State regulations are updated quarterly; we currently have two versions available. Below is a comparison between our most recent version and the prior quarterly release. More comparison features will be added as we have more versions to compare.
No prior version found.