Archived News Items
The Alaska Medicaid electronic file transfer (EFT) for this week's payment cycle, scheduled for Friday, November 29, 2019, has been delayed one business day until Monday, December 2, 2019. The division regrets any inconvenience this may cause. Questions? Contact Carmela Sargento, Division of Health Care Services' Finance and Recovery Unit, at firstname.lastname@example.org or 907.334.2402.
Posted: 11/29/2019 Archived: 12/03/2019
DHSS and ASHNHA Reach Cost Containment Regulations Settlement
The Department of Health and Social Services (DHSS) and Alaska State Hospital and Nursing Home Association (ASHNHA) have settled the pending litigation related to cost containment regulations. The 10/02/2019 press release, ASHNHA and State Reach Settlement Over Cost Containment Regulations, is available on the Provider Updates page. Providers who wish to request reimbursement under the terms of the settlement must submit, by 11/01/2019, an Emergency Cost Containment Reimbursement Adjustment Request form, also available on the Provider Updates page. Answers to Frequently Asked Questions are available on the on the Provider Updates page.
Posted: 10/14/2019 Archived: 11/20/2019
Enhanced Adult Dental Program Extended Through 9/30/2019
Coverage for adult enhanced (preventive) dental services has been extended until 09/30/2019. Members will be notified of the coverage extension by letter. The letter is available on the Member page.
New SA Requests
New SA requests for adult enhanced dental services will be considered for coverage if received by Conduent by 5:00 p.m. AKT, 09/30/2019 and the treatment
- was performed on or after 07/01/2019 or
- is scheduled to be initiated on or before 09/30/2019.
Previously Denied SA Requests
SA requests that were submitted on or after 07/01/2019 and were denied because the program was unfunded will be reconsidered; do not resubmit previously denied service authorizations. You will be notified of all SA approvals.
Completion of Treatment
All services must be completed by 10/31/2019.
Coverage for dentures is not ending and therefore not subject to the 10/31/2019 completion date. Dentures are not considered a service under AED and will be approved up to the member's denture limit, if medically necessary.
If you have any questions, please contact Carrie Crouse at 907.334.2403 or Sherri Larue at 907.334.2656.
Posted: 09/04/2019 Archived: 11/20/2019
Dental Service Authorization Request Requirements
Dental service authorization requests must include the specific date on which the service will be provided, the exact service that will be provided, and may be submitted only if an appointment has already been scheduled. Authorization requests that include span dates; blanket or unspecified services; unscheduled services; or otherwise do not meet these requirements will be returned to the provider.
Questions? Contact Carrie Crouse at 907.334.2403 or Sherri LaRue at 907.334.2656.
Posted: 08/30/2019 Archived: 11/20/2019
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
Alaska Medicaid Announces New Vision Contractor
The Division of Health Care Services is pleased to announce that Classic Optical has been selected as Alaska Medicaid's new eyeglass contractor. Welcome packets containing information on how to place orders will be mailed to you soon, and Classic Optical will hold training sessions in Anchorage, Fairbanks, and Juneau. Training dates will be announced in the coming weeks.
The department would like to thank Rochester Optical for their 15 years of service to the Alaska Medicaid program.
Questions? Contact Ryan Bender at email@example.com or 907.334.2419..
Posted: 08/13/2019 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
Adult Enhanced Dental Program Unfunded as of July 1, 2019
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 will pay for authorized adult enhanced dental services completed prior to July 1, 2019, and for seatment or completion of authorized services that commenced prior to July 1, 2019. Adult emergency dental services are unaffected and will continue to be covered. Fee schedules will be updated in the coming weeks. Additional information about coverage for dentures and denture-related services will be released in the coming weeks. Until that time, service authorization requests for dentures will be denied. If you have any questions, please contact Provider Inquiry at 800.770.5650, option 1, 1, 1 or the Division of Health Care Services' Medicaid dental program manager, Carrie Crouse, at 907.334.2403 or Sherri Larue, at 907.334.2656.
Posted: 07/01/2019 Archived: 11/20/2019
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 firstname.lastname@example.org. 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.
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 email@example.com.
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