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News


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



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 ryan.bender@alaska.gov or 907.334.2419.


Posted: 08/13/2019



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



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



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: 5/28/2019



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: 3/11/2019



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: 2/22/2019



Archived News Items



Training


Opioid Training/CEU Opportunity for Licensed Professionals


New Alaska legislation requires a minimum of two hours of continuing education in pain management, opioid use, and addiction for prescribing providers (unless you do not hold a valid DEA registration). For information on applicable courses, view the following flyers:



Medicaid Provider Training Schedule


Regulations and Public Notices



Proposed Regulations: 72 Hour Documentation Requirement and Provider Self-Audits


On August 14, 2019, the Department of Health and Social Services issued a public notice announcing proposed changes to the 72 hour documentation rule and provider self-audits regulations. The public comment period ends on October 2, 2019 at 5:00 p.m. AKT. The proposed regulations are available at Alaska Online Public Notices.


Posted: 08/15/2019



Proposed Regulations: HCBW and Day Habilitation Services


On August 8, 2019, the Department of Health and Social Services issued a public notice announcing proposed regulations to implement changes to home and community based waiver and day habilitation services. The public comment period ends on September 30, 2019 at 5:00 p.m. AKT. The proposed regulations are available at Alaska Online Public Notices.


Posted: 08/12/2019



Public Hearing: Proposed HCBW and Day Habilitation Services Regulations


On August 8, 2019, the Department of Health and Social Services issued a public notice announcing proposed regulations to implement changes to home and community based waiver and day habilitation services. Public hearing will be held from 2:00 p.m. – 4:00 p.m. and from 5:00 p.m. – 7:00 p.m. AKT on September 13, 2019 at the Atwood Building, Room 102, 550 W. 7th Avenue, Anchorage, AK 99503, at which time oral and written comments will be accepted. The public hearing notice, notice of proposed regulations, and additional information are available at Alaska Online Public Notices.


Posted: 08/12/2019



Proposed Regulations: Medicaid Telemedicine Coverage and Payment


On August 9, 2019, the Department of Health and Social Services issued a public notice announcing proposed changes to Medicaid telemedicine services regulations. The public comment period ends on September 27, 2019 at 5:00 p.m. AKT. The proposed regulations are available at Alaska Online Public Notices.


Posted: 08/12/2019



Public Hearing: Medicaid Telemedicine Coverage and Payment


On August 9, 2019, the Department of Health and Social Services issued a public notice announcing proposed regulations to implement changes to Medicaid telemedicine services. A public hearing will be held from 2:00 p.m. – 4:00 p.m. AKT on September 13, 2019 at the Frontier Building, Room 880/890, 3601 C Street, Anchorage, AK 99503, at which time oral and written comments will be accepted. The public hearing notice, notice of proposed regulations, and additional information are available at Alaska Online Public Notices.


Posted: 08/12/2019



Proposed Regulations: Health Care Services Price Transparency


On July 18, 2019, the Department of Health and Social Services issued a public notice announcing proposed regulations to implement AS 18.23.400 that requires disclosure and reporting of health care services, price, and fee information. The public comment period ends on September 27, 2019 at 5:00 p.m. AKT. The proposed regulations are available at Alaska Online Public Notices.


Posted: 07/22/2019



Public Hearing: Proposed Health Care Services Price Transparency Regulations


On July 18, 2019, the Department of Health and Social Services issued a public notice announcing proposed regulations to implement AS 18.23.400 that requires disclosure and reporting of health care services, price, and fee information. A public hearing will be held from 1:00 p.m. – 3:00 p.m. AKT on August 28, 2019 at 3601 C Street, Room 880, Anchorage, AK 99503, at which time oral and written comments will be accepted. The public hearing notice, notice of proposed regulations, and additional information are available at Alaska Online Public Notices.


Posted: 07/22/2019



Emergency Medicaid Regulations Filed: 1115 Waiver Services Coverage and Payment


Emergency Medicaid 1115 Waiver Services Coverage and Payment regulations are effective July 1, 2019. The regulations are available at https://aws.state.ak.us/OnlinePublicNotices/Notices/View.aspx?id=194744


Posted: 07/01/2019



Emergency Medicaid Regulations Filed: Cost Containment


Emergency Medicaid cost containment regulations are effective July 1, 2019. The regulations are available at https://aws.state.ak.us/OnlinePublicNotices/Notices/View.aspx?id=194742 and https://aws.state.ak.us/OnlinePublicNotices/Notices/View.aspx?id=194743.


Posted: 07/01/2019



Delayed Implementation of Durable Medical Equipment Regulations


Durable medical equipment (DME), prosthetics and orthotics (P&O) and supplies regulations were adopted by the Department of Health and Social Services and filed by the Lieutenant Governor with a June 2, 2019 effective date. Implementation of the DME segment of the regulations has been postponed until July 2, 2019; all other segments of the regulations will be implemented on June 2, 2019 as planned. For more information, see “DME/P&O Regulations: FAQs” available on the Provider Updates page.


Posted: 06/04/2019



Medicaid Regulations Filed: Medicaid Home and Community-Based Waiver, Nursing Oversight, and Care Management Services


New Medicaid home and community-based waiver, nursing oversight, and care management services were adopted by the Department of Health and Social Services, filed by the Lieutenant Governor, and are effective June 13, 2019. The signed regulations are available at https://aws.state.ak.us/OnlinePublicNotices/Notices/View.aspx?id=194279.


Posted: 05/15/2019



Proposed Regulations: Medicaid Behavioral Health Services and Requirements for Behavioral Health Providers


On May 13, 2019, the Department of Health and Social Services issued a public notice announcing proposed regulation changes to behavioral health services. The public comment period ends on July 29, 2019 at 5:00 p.m. AKT.


The proposed regulations and additional details are available at Alaska Online Public Notices.


Posted: 05/14/2019




Archived Regulations and Public Notices



Provider Resources


Enhanced Automated Voice Response System


Call 855.329.8986 to access the following information:

 

- Member Eligibility
- Claim Status
- Provider Remittance Advice
- Service Authorization Schedule
- Fee Schedules
- Service Limits

 

The new AVR system is available 24 hours per day, seven days per week, aside from scheduled maintenance periods. Callers must identify themselves using an active provider number and Personal Identification Number (PIN). Your PIN is assigned as part of the Provider Enrollment process and can be maintained via the AVR.

To learn more about the AVR system, the computer based training module AVR Overview is available on the Alaska Medicaid Learning Portal. You may also reference the Enterprise Quick Reference - AVR.


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