Alaska Administrative Code
Title 7 - Health and Social Services
Part 3 - Public Assistance and Medical Assistance
Chapter 47 - General Relief
Article 1 - General Relief and General Relief Medical
7 AAC 47.210 - Exclusions from General Relief Medical program
Universal Citation: 7 AK Admin Code 47.210
Current through November 28, 2024
(a) Notwithstanding any other provisions contained in this chapter or 7 AAC 105 - 7 AAC 160, a payment may not be made under the General Relief Medical program for any expense
(1) that is for major medical care
not determined necessary by the professional review organization on contract
with the division of medical assistance;
(2) that is for nursing home care not
approved by the division of medical assistance;
(3) for items and services not properly
prescribed or determined necessary by a health care practitioner;
(4) for more than 12 outpatient physician
visits by a recipient in a calendar year;
(5) for outpatient physician visits that are
not for a recipient with a diagnosis as described in
7
AAC 47.271(b);
(6) if persons are in the care and custody of
penal facilities, including juveniles in detention facilities;
(7) for an elective procedure, including an
elective abortion;
(8) if the
expense is for the first $50 of each day of hospital stay up to a maximum of
$200 per hospital admission for major medical care;
(9) if the expense is for a prescription drug
or prescribed medical supply for a recipient who does not have a diagnosis
specified in
7
AAC 47.271(b);
(10) repealed 7/1/87;
(11) for room, board or ancillary services
provided in a hospital beyond the length of hospitalization stay authorized in
7
AAC 47.245;
(12) for a service provided on or after
August 1, 1998.
(b) Notwithstanding any other provisions contained in this chapter or 7 AAC 105 - 7 AAC 160, the General Relief Medical program will not pay for any service provided by an Indian Health Service or Indian Health Service funded facility that is provided to an Indian Health Service beneficiary and for which there is no charge to the individual.
Authority:AS 47.05.010
AS 47.25.120
AS 47.25.130
AS 47.25.170
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