The federal government has given permission in emergency cases for the state to enroll new Medicaid waiver clients, despite a federal moratorium imposed after finding problems with the state's management of the program.
Alaska has a waiver from Medicaid regulations to allow federal money to be used for home- and community-based care.
The federal Centers for Medicaid and Medicare Services (CMS) said the state was failing to assess and re-assess those seeking services under the waiver in a timely manner and suspended it June 26.
The state Department of Health and Social Services has announced a plan for the state to work its way out of the moratorium, including a strategy for working through the backlog of assessments.
The emergency action announced Monday will allow the state an exception to the moratorium for emergency cases.
The state is "deeply relieved" to be able to provide the services, even if it only affects a few emergency cases, said Bill Hogan, commissioner of the department, in a Monday press release.
The exception applies to potential clients in one of several situations:
someone with a terminal diagnosis of six months or less;
within 90 days of the death of a primary caregiver;
emergency absence of a primary care giver anticipated to be discharged from an acute care facility within seven days; or
in some conditions with an adult or children's services referral.
The federal government had earlier lifted a portion of the moratorium on Personal Care Assistance services, a program unrelated to the Medicaid waiver but which had originally been included in the moratorium.
Hogan said that despite the progress made at lifting the moratorium so far, further work was needed to address the federal government's concerns.
"We are acutely aware that Alaskans who are not in an emergency situation are still very vulnerable, and we are working diligently with CMS to guarantee the rigorous safety standards necessary for this level of care and to lift the moratorium completely as quickly as possible," Hogan said.
The four waivers programs that remain under the moratorium barring new enrollments are for People with Mental Retardation and Developmental Disabilities, Older Alaskans, Adults with Physical Disabilities, and Children with Complex Medical Conditions.
The four programs had about 3,700 clients at the time of the moratorium, but it did not affect those already receiving services.
Contact reporter Pat Forgey at 523-2250 or firstname.lastname@example.org.
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