Sec. 47.08.150. Assistance for chronic or acute medical conditions.

590 words·~3 min read·/ak/title-47/chapter-8/47-08-150·

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(a)Under the provisions of this section, the Department of Health may pay providers of medical care for services described in

(c)of this section that are provided to needy persons suffering from a chronic or acute medical condition who may apply for assistance under

(b)of this section.

(b)A needy person suffering from a chronic or an acute medical condition who is eligible for general relief assistance under AS 47.25.120 and is not eligible for the medical assistance program under AS 47.07 may apply for assistance under this section. The department shall make a determination of eligibility based on a general relief assistance application. The requirements of AS 47.08.020 — 47.08.140 do not apply to assistance sought under this section, except that, notwithstanding

(c)of this section, neither reimbursement nor assistance may be paid by the department for services that are listed in AS 47.08.050 as those services are defined in AS 47.08.140 . The department shall establish an electronic application for assistance under this section. The department shall allow an applicant to complete and submit a secure electronic application for assistance through the department's Internet website. The electronic application must inform an applicant that a false statement made on the application will be investigated and is punishable under AS 11.56.210 .

(c)The services eligible for payment under this section for a needy person with a chronic or acute medical condition are the following:

(1)prescription drugs and medical supplies prescribed to treat a person who has

(A)a terminal illness;

(B)cancer and requires chemotherapy; or

(C)a chronic condition that would normally, in its untreated course, result in the death or disability of the recipient, but that is amenable to outpatient medication; the chronic conditions for which the cost of prescription drugs may be paid include the following diagnoses:

(i)diabetes and diabetes insipidus;

(ii)seizure disorders;

(iii)chronic mental illness;

(iv)hypertension;

(2)physician services

(A)related to care under

(3)of this subsection;

(B)provided in a hospital emergency room the same day on which the recipient is admitted for care under

(3)of this subsection;

(C)provided to a recipient residing in a nursing home; or

(D)provided in either an outpatient or an inpatient setting to a recipient with a diagnosis described in

(1)of this subsection;

(3)inpatient hospital services that cannot be performed on an outpatient basis and that are certified as necessary by a professional review organization consulted by the Department of Health but not including inpatient psychiatric hospital services;

(4)outpatient laboratory and x-ray services;

(5)medical transportation related to care under

(3)of this subsection or nursing facility care;

(6)outpatient surgical services;

(7)nursing facility care.

(d)The payment rate for facilities under this section shall be the same as that established by regulation for medical services under AS 47.25.195 , and payment rates under this section for other providers may not exceed those established under AS 47.07 .

(e)The Department of Health may limit the amount, duration, and scope of services covered under this section by regulation. If the Department of Health finds that the cost of assistance for all persons eligible under this section will exceed the amount allocated for that assistance during the fiscal year, the Department of Health may limit coverage for certain medical services by regulation in order to provide the most critical care within the available appropriations.

(f)The Department of Health may adopt regulations to implement this section.