(a) The department shall offer all mandatory services required under 42 U.S.C. 1396 - 1396p (Title XIX of the Social Security Act).
(b) In addition to the mandatory services specified in (a) of this section and the services provided under (d) of this section, the department may offer only the following optional services: case management services for traumatic or acquired brain injury; case management and nutrition services for pregnant women; personal care services in a recipient's home; emergency hospital services; long-term care noninstitutional services; medical supplies and equipment; advanced nurse practitioner services; clinic services; rehabilitative services for children eligible for services under AS 47.07.063 , substance abusers, and emotionally disturbed or chronically mentally ill adults; targeted case management services; inpatient psychiatric facility services for individuals 65 years of age or older and individuals under 21 years of age; psychologists' services; clinical social workers' services; midwife services; prescribed drugs; physical therapy; occupational therapy; chiropractic services; low-dose mammography screening, as defined in AS 21.42.375 (e); hospice care; treatment of speech, hearing, and language disorders; adult dental services; prosthetic devices and eyeglasses; optometrists' services; intermediate care facility services, including intermediate care facility services for persons with intellectual and developmental disabilities; skilled nursing facility services for individuals under 21 years of age; and reasonable transportation to and from the point of medical care.
(c) Notwithstanding (b) of this section, the department may offer a service for which the department has received a waiver from the federal government if the department was authorized, directed, or requested to apply for the waiver by law or by a concurrent or joint resolution of the legislature.
(d) The department may establish as optional services a primary care case management system or a managed care organization contract in which certain eligible individuals are required to enroll and seek approval from a case manager or the managed care organization before receiving certain services. The department shall establish enrollment criteria and determine eligibility for services consistent with federal and state law.
(e) The department shall provide the services set out in (a) and (b) of this section to an eligible person, notwithstanding the person's participation in an approved clinical trial. In this subsection, "approved clinical trial" has the meaning given in AS 21.42.415 .
(f) When the department authorizes the purchase of durable medical equipment under this section, the department may require a recipient of medical assistance services to purchase used or refurbished durable medical equipment if used or refurbished durable medical equipment
(1) is available;
(2) is less expensive, including shipping, than new durable medical equipment of the same type;
(3) is able to withstand at least three years of use; and
(4) equally meets the needs of the recipient.
(g) In this section,
(1) "case management services for traumatic or acquired brain injury" means services furnished to assist individuals who reside in a community setting or who are transitioning to a community setting to gain access to needed medical, social, educational, and other available services;
(2) "durable medical equipment" means equipment that
(A) can withstand repeated use;
(B) is primarily and customarily used to serve a medical purpose;
(C) generally is not useful to an individual in the absence of an illness or injury; and
(D) is appropriate for use in the home, school, or community.
(3) "traumatic or acquired brain injury" has the meaning given in AS 47.80.529.
Section: Previous 47.07.010 47.07.020 47.07.025 47.07.030 47.07.032 47.07.035 47.07.036 47.07.040 47.07.042 47.07.045 47.07.046 47.07.050 47.07.055 47.07.060 47.07.063 NextLast modified: November 15, 2016