State of Alaska Department of Health and Social Services, Division of Public Assistance TEFRA Program

Overview

The Tax Equity and Fiscal Responsibility Act of 1982 (TEFRA) is a Medicaid program designed to help children under 19 years old with costs related to their disabilities. This covers significant medical, developmental or psychiatric needs. Though they may be deemed “disabled” or have high medical costs, not all children qualify for this program.

Criteria to Qualify for Alaska Medicaid TEFRA

To qualify, your child must meet one of the following three "level of care" criteria:

1. Intermediate Care Facility for the Mentally Retarded (ICF/MR)
2. Nursing Facility (skilled and/or intermediate) (NF)
3. Inpatient Psychiatric Hospital (IPH)

Each of these categories has specific criteria, so not all children who receive one of these three levels of care will qualify for Alaska Medicaid - TEFRA.

Applying for TEFRA

You can apply through the State of Alaska Department of Public Assistance (DPA). The DPA is the central agency in all TEFRA Medicaid eligibility decisions. A DPA caseworker will verify whether or not your child meets the basic requirements for TEFRA assistance. They will also contact Qualis Health to make a medical determination.

Qualis Health’s Role

When Qualis Health is contacted about your case by the DPA, we will:

• Open an Alaska Medicaid - TEFRA application for your child
• Send you a letter with a list of care coordinators to choose from
• Work with your chosen care coordinator to ensure that the correct forms are submitted on time
• Track the progress of any new or renewed applications

TEFRA Resources

• Alaska Medicaid - TEFRA Frequently Asked Questions
• Alaska Medicaid - TEFRA Brochure
• Alaska Medicaid - TEFRA Definitions
• Alaska Medicaid - TEFRA Application Process Chart
• Case Examples
• HIPP Form
• Care Coordinator Contact Lists:
  • Bethel Region
  • Cordova/Valdez Region
  • Kenai Peninsula/Kodiak Region
  • Northern Region
  • Southcentral Region
  • Southeast Region