Archived News Items


Medically Necessary Early Refills due to Wildfires


Due to wildfires around the state, the Department of Health and Social Services is granting flexibility regarding early refills of Medicaid-covered medications. For more information, please visit the Medicaid Pharmacy page to view the provider letter Medically Necessary Early Refills due to Wildfires.


Posted: 08/22/2019 Archived: 09/24/2019


Enhanced Adult Dental: Member in Mid-Treatment


The adult enhanced (preventive) dental program is unfunded effective July 1, 2019. All service authorization requests and claims for adult preventive services with dates of service on and after July 1, 2019 will be denied.


The department may pay for crowns and dentures if the treatment began prior to, but was not completed by, July 1, 2019 and only if the following conditions are met:

  • The initial services were prior authorized or the treatment plan supports that completion of treatment is medically necessary.
  • No later than 5:00 p.m. AKT August 30, 2019, the dental provider submits a new service authorization (SA) request for completion of treatment; the SA must include the relevant procedure code(s) for the services to be performed and documentation supporting the medical necessity for completion of treatment and supporting documentation that shows treatment began prior to July 1, 2019.

If services were in mid-treatment and an authorization was denied after July 1, 2019, you may resubmit the authorization request for reconsideration.


Questions? Please contact Provider Inquiry at 800.770.5650, option 1, 1, 1, the Division of Health Care Services’ Medicaid dental program manager, Carrie Crouse, at 907.334.2403 or dental program supervisor, Sherri LaRue, at 907.334.2656.


Posted: 07/29/2019 Archived: 08/26/2019


Medicaid Budget Supplemental Prevents Medicaid Payment Delays


On May 28, 2019, the Department of Health and Social Services announced that Medicaid payments during the last 3 weeks of June would be delayed until the first week of July due to a budget shortfall. The department is pleased to announce that the requested supplemental to cover the budget shortfall has been approved. At this time, no payments have been delayed and the department expects to pay all Medicaid claims based on normal processing times with no budget shortfall delays.


Posted: 06/11/2019 Archived: 07/01/2019


Letter from the Director: Budget-Pended Payments


Dear Medicaid Provider,


As the Department of Health and Social Services approaches the end of the state fiscal year, again we are challenged by a budget shortfall. In order to manage this projected deficit between the authorized budget for the current fiscal year ending June 30, 2019 and claims received from enrolled providers, the department has modified the weekly provider payment schedule.


Over the final three weeks of the fiscal year, the department will delay issuance of payments for some claims to 30 days as allowed under federal regulations (42 C.F.R. 447.45) which require payment of 90 percent of claims within 30 days of receipt and 99 percent of claims within 90 days of receipt.


Providers whose claims are delayed will see affected claims on the weekly remittance advice (RA) with the status of "O", and "Budget Funded". Because billed charges and Medicaid reimbursement amounts often differ, the total of all "O" delayed claims may not equal the cumulative total shown on the summary page.


Please continue to submit claims to expedite payment once payments resume in full. All claims will continue to be processed under standard adjudication rules. More information is available at http://manuals.medicaidalaska.com/docs/updates.htm (see "Budget-Delayed Medicaid Payments FAQs").


I will keep you informed of our progress through additional remittance advice messages. In the interim, please forward any comments, suggestions, or questions you may have to Susan Dunkin at susan.dunkin@alaska.gov. Thank you for the services you continue to provide to Alaska's most vulnerable residents, and for your patience and cooperation as we work together to navigate Alaska's fiscal challenges.


Sincerely,


Renee Gayhart
Director


Posted: 05/28/2019 Archived: 06/11/2019


Providers Must Submit Original (Red) CMS-1500, UB-04, and ADA (J434) Claim


This is a reminder that providers must submit paper claims on original red CMS-1500, UB-04, or ADA (J434 version) claim forms. Alaska Medicaid utilizes Optical Character Recognition (OCR) technology for the processing of paper claims. OCR is able to read original red CMS-1500, UB04, and ADA claim forms only. Black, photocopied or faxed claim forms cannot be read. After June 30, 2019, this will be strictly enforced and Conduent will RTP (return to provider) any claims not submitted on an original red claim form. Black, photocopied, or faxed claims will no longer be accepted after this date.


Providers may also submit claims electronically with Alaska Medicaid through billing software and Health Enterprise.


Posted: 05/28/2019 Archived: 09/25/2019


Provider Revalidation Open House May 28 - 31


Did you receive an Alaska Medicaid provider revalidation notice? If so, have you completed your revalidation? Alaska Medicaid is offering an open house to assist providers who have not yet completed their required revalidation. The open house will be held daily, May 28 - 31, from 1:30 p.m. - 4:30 p.m. at 1835 Bragaw St. Suite 300. Staff members will be available to answer questions and assist you with your revalidation forms. If you have any questions or are unsure if you are required to revalidate your enrollment, please contact Provider Enrollment at AK-Enrollment@conduent.com, 907.644.6800, option 2, or 800.770.5650, option 1, 3.


Posted: 05/21/2019 Archived: 06/03/2019


UnitedHealthcare: Alaska Managed Care Plan Update


Senate Bill 74 (2016) established the Coordinated Care Demonstration Project, to test the efficacy of new models of care in Alaska. In compliance with this initiative, the Department of Health and Social Services has contracted with UnitedHealthcare to provide managed care for Medicaid members within the Municipality of Anchorage and the Matanuska-Susitna Borough. The anticipated go-live date for this program is October 1, 2019. For more information regarding this managed care project, please see the April 1, 2019 flyer "UnitedHealthcare - Alaska Managed Care Plan" available on the Provider Updates page.


Posted: 04/01/2019 Archived: 07/01/2019


Qualis Health is now Comagine Health


Effective February 11, 2019, Qualis Health officially became Comagine Health. The names "Qualis Health" and "Comagine Health" will be used interchangeably until the name change has been fully implemented (e.g., provider portal, links, email addresses). The corporate address and phone numbers will remain the same. In April 2019, email addresses will change to Comagine Health, however, until further notice current Qualis Health email addresses will remain active and will be automatically forwarded to the appropriate recipient. Watch your RA messages for further updates.


Questions? Contact Susan Dunkin at susan.dunkin@alaska.gov.


Posted: 03/11/2019 Archived: 09/25/2019


Contemporaneous Documentation Requirements: Update


On November 13, 2018, the American Medical Association (AMA) adopted documentation standards, Resolution 804 (I-18) Arbitrary Documentation Requirements for Outpatient Services (Policy D-320.985, for AMA members). The Department of Health and Social Services has determined that physician application of AMA standards D-320.985 meets the contemporaneous documentation requirements of 7 AAC 105.230(d)(7).


Posted: 02/22/2019 Archived: 09/25/2019


Notice of Alaska's Health Care Price Transparency Law (SB 105)


Alaska's new health care price transparency law requires health care providers and facilities to post the prices of their most common procedures. Despite the law's effective date of January 1, 2019, the Department of Health and Social Services will allow health care providers and facilities more time to comply with the law until implementing regulations are in effect.


For more information, see the Notice of Alaska's Health Care Price Transparency Law. For the full text of the enrolled bill, see SB105.


Posted: 12/28/2018 Archived: 05/08/2019


Administrative Relief in Response to Earthquake in Southcentral Alaska


The Department of Health and Social Services is granting flexibility and administrative relief to Medicaid-enrolled providers in Southcentral Alaska who were impacted by the November 30, 2018 earthquake. For more information, please visit the Medicaid Program Integrity page (http://dhss.alaska.gov/Commissioner/Pages/ProgramIntegrity/default.aspx) to view the Administrative Relief to Providers in the Earthquake Affected Areas and the Provider Attestation Form: Medical Records Destroyed by Disaster documents.


Posted: 12/18/2018 Archived: 05/08/2019


CMS Declares Alaska Public Health Emergency


In response to the 7.0 earthquake that occurred in southcentral Alaska on November 30, 2018, U.S. Health and Human Services Secretary Alex Azar declared a public health emergency in Alaska following the President's emergency declaration on December 3, 2018. This declaration allowed the Centers for Medicare and Medicaid Services to grant an 1135 Waiver to aid healthcare facilities in providing uninterrupted care and long-term care facilities in providing care to Alaskans who are elderly or disabled.


The following documents provide additional information about the emergency declaration and the 1135 Waiver:



Posted: 12/18/2018 Archived: 05/08/2019


CMS Certifies Alaska Medicaid MMIS


On September 28, 2018, the Centers for Medicare and Medicaid Services approved the Department of Health and Social Services' request for certification of its Medicaid Management Information System (MMIS). Certification allows the department to receive 75 percent Federal Financial Participation (FFP) funds for costs associated with implementation of the system.


Posted: 10/02/2018 Archived: 02/22/2019