900             INTRODUCTION AND GENERAL PROVISIONS

The Chronic and Acute Medical Assistance (CAMAChronic and Acute Medical Assistance) program began July 1, 1999.  CAMAChronic and Acute Medical Assistance is available only after a financially qualified applicantAny individual who completes an application for assistance has exhausted all other available resources.  It was originally designed to pay health care providers who serve the needy individuals suffering from acute and certain chronic medical conditions who are not eligible for MedicaidA needs based program that pays for medical care provided to individuals who are categorically and financially eligible. General eligibility categories include pregnant women; dependent children; individuals needing an institutional level of care; and aged, blind, and disabled individuals..  CAMAChronic and Acute Medical Assistance is entirely state funded. The number of individuals covered and the medical services provided by CAMAChronic and Acute Medical Assistance are dependent on the level of funding available each year.

Beginning November 1, 2002, due to a significant reduction in state funding, CAMAChronic and Acute Medical Assistance was reduced to primarily a maintenance prescription drug program.  The first month of eligibility for CAMAChronic and Acute Medical Assistance changed to the month after application, instead of the month of application.  Inpatient hospitalization coverage was eliminated except for the persons identified below.  Retroactive coverage was also eliminated.

Effective September 20, 2003, CAMAChronic and Acute Medical Assistance no longer pays for inpatient hospital care, nursing home care, and transportation services.  Prescription drugs are limited to three approved prescriptions within a calendar month per recipientAn individual who is receiving a public assistance program. and Medical supplies will only be reimbursed if they are related to the administration of a drug product needed to treat one of the covered conditions listed below.  

To be eligible for CAMAChronic and Acute Medical Assistance, a person must be terminally ill , have cancer requiring chemotherapy, or have one of the following chronic conditions: (1) diabetes and diabetes insipidus; (2) seizure disorders; (3) mental illness; and (4) hypertension.

CAMAChronic and Acute Medical Assistance pays for:

• prescribed drugs (maximum 3 per month) and limited medical supplies (maximum 30 day supply);
  
  
• physician visits;
  
  
• chemotherapy and radiation treatment on an outpatient basis; and
  
  
• outpatient laboratory and x-ray services

900-1          CONFIDENTIALITY

It is against the law to use or disclose information obtained from an applicantAny individual who completes an application for assistance or recipientAn individual who is receiving a public assistance program. unless it is to a person directly connected with the administration or enforcement of the CAMAChronic and Acute Medical Assistance program or other public assistance program.  Refer to Section 100-3 of the Administrative Procedures Manual.

900-2           FRAUD

The misrepresentation of fact or omission of information with the intent of illegally obtaining service, payment, or other gain constitutes Medical Assistance fraud.  Medical Assistance Fraud exists when a recipientAn individual who is receiving a public assistance program. intentionally fails to report income, resources, household composition or other factors that may affect CAMAChronic and Acute Medical Assistance eligibility.

Persons knowingly and willingly aiding a recipientAn individual who is receiving a public assistance program. or providerAny doctor or health facility which has agreed to provide medical services to recipients under the medical assistance program. in committing Medical Assistance fraud are considered to be aiding in the commission of the act and may be held responsible.  This is in accordance with AS 47.05.210.  Refer to Section 112 of the Administrative Procedures Manual.