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. Although 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 these three "level of care" criteria:
- Intermediate Care Facility for Individuals with Intellectual Disabilities (ICF/IID)
- Nursing Facility (skilled and/or intermediate) (NF)
- Inpatient Psychiatric Hospital (IPH)
Each category 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
Apply for TEFRA through the State of Alaska, Division of Public Assistance (DPA). The DPA is the central agency in all TEFRA Medicaid eligibility decisions.
- A DPA eligibility team member will verify whether your child meets the basic requirements for TEFRA assistance.
- They will also contact Comagine Health to make a medical determination.
If you have questions about applying for the Alaska Medicaid — TEFRA program, please contact the DPA Policy and Program Development unit at 907-465-3382 or hss.dpa.offices@alaska.gov.
Comagine Health's Role
After the DPA contacts us about your case, Comagine Health 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 care coordinator to ensure that the correct forms are submitted on time
- Track the progress of any new or renewed applications
March 19, 2020 — COVID-19 and Business Continuity
During the current COVID-19 emergency, Comagine Health is fully staffed and business operations are not interrupted.
For utilization review, case management and related activities, we are continuing to process requests and answer calls via our toll-free numbers during standard business hours. We have business continuity plans in place to serve our clients, health care providers, patients and communities while also protecting our staff and minimizing the spread of the illness.