Alaska Administrative Code
Title 7 - Health and Social Services
Part 7 - Medicaid Assistance Eligibility
Chapter 100 - Medicaid Eligibility
Article 15 - General Provisions
7 AAC 100.990 - Definitions

Universal Citation: 7 AK Admin Code 100.990

Current through August 30, 2024

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;

(20) "Family Medicaid" means medical assistance provided under 7 AAC 100.100 - 7 AAC 100.199;

(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);

(50) "SSI" means supplemental security income under 42 U.S.C. 1381 - 1383 f;

(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;

(52) "Title IV-E" means 42 U.S.C. 670 - 675 (Title IV-E of the Social Security Act);

(53) "Transitional Medicaid" means medical assistance provided under 7 AAC 100.200 - 7 AAC 100.209;

(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.

Authority:AS 47.05.010

AS 47.07.020

AS 47.07.040

Disclaimer: These regulations may not be the most recent version. Alaska may have more current or accurate information. We make no warranties or guarantees about the accuracy, completeness, or adequacy of the information contained on this site or the information linked to on the state site. Please check official sources.
This site is protected by reCAPTCHA and the Google Privacy Policy and Terms of Service apply.