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

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 the following three "level of care" criteria:

1. Intermediate Care Facility for Individuals with Intellectual Disabilities (ICF/IID)
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

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

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: Special Announcement About COVID-19

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.

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 Application
• Care Coordinator Contact Lists:
  • Bethel Region
  • Cordova/Valdez Region
  • Kenai Peninsula/Kodiak Region
  • Northern Region
  • Southcentral Region
  • Southeast Region

Adobe Acrobat® PDF files can be opened using Adobe Acrobat Reader. If you do not have Acrobat Reader, you can get it free from the Adobe website.