1. (a) Except as provided in this section, the department will not reimburse Medicaid services provided to a Medicaid-eligible individual while the individual resides in a public institution, regardless of whether placement was voluntary or involuntary, unless the individual is

   1. (1) living in a public institution solely to receive educational or vocational training;
   2. (2) placed in a public institution on a short-term emergency basis pending placement in a living arrangement appropriate to the individual's needs;
   3. (3) living in a correctional facility or juvenile facility but received medical care while an inpatient in a medical institution for at least 24 hours; or
   4. (4) living in a substance abuse treatment facility or a halfway house that has a contract with the state to provide treatment and monitoring.

2. (b) The following individuals living in a public institution may become Medicaid-eligible while residing in, or retain their existing eligibility upon entry into, the public institution, if all applicable Medicaid eligibility requirements are met:

   1. (1) a prisoner who is in a correctional facility under AS 33.30;
   2. (2) a delinquent minor who is in the custody of the department under AS 47.12.120(b)(1) or 47.12.240.

3. (c) In this section,

   1. (1) "correctional facility" has the meaning given in AS 33.30.901;
   2. (2) "delinquent minor" has the meaning given in AS 47.12.990;
   3. (3) "juvenile facility" has the meaning given in 7 AAC 52.900;

   4. (4) "prisoner"

      1. (A) has the meaning given in AS 33.30.901;

      2. (B) includes an individual who

         1. (i) is on temporary furlough; or
         2. (ii) has temporarily left a correctional facility or public institution for treatment in an acute care medical facility;

   5. (5) "public institution"

      1. (A) means an institution, including a correctional facility or juvenile detention facility, that is the responsibility of a governmental unit or over which a governmental unit exercises administrative control;
      2. (B) does not include a medical institution.

(Eff. 7/20/2007, Register 183; am 1/1/2011, Register 196; am 9/20/2015, Register 215)

Authority: AS 47.05.010, AS 47.07.020, AS 47.07.040