Adult Enhanced Dental Program
DHSS issued a press release on Dec. 13, 2019, announcing the reinstatement of Alaska’s adult preventive dental program (also known as the Adult Enhanced Dental Program) for Medicaid recipients effective Dec. 31, 2019. Program services will be retroactively covered to Oct. 1, 2019. Health Care Services notified Medicaid recipients by direct mail and Medicaid providers via remittance advice message. Click here for more information.
Golden Ticket Pilot Project Ending Dec. 31, 2019
In December 2018, specified providers were notified that they were chosen to participate in a pilot project that offered an exemption from obtaining service authorizations. On Dec. 31, 2019, the project will end and will not be renewed. G-authorization numbers issued to selected providers will continue to be valid for dates of service through Dec. 31, 2019. For dates of service on and after Jan. 1, 2020, please resume submission of prior authorization requests to the appropriate entity (e.g., Conduent State Healthcare, Comagine Health, formerly known as Qualis Health). If you are unsure where to submit a prior authorization request, please refer to your provider billing manual.
Questions? Contact Brenda Vincent (907) 334-2430 or Jamie Walker (907) 334-2406.
72 Hour Documentation Requirement and Provider Self-Audits
DHSS has proposed to adopt regulation changes dealing with the Medicaid provider 72 hour documentation rule and provider self-audits. The proposed regulation change would adopt a 14-day documentation standard for all providers, among other changes. The comment period for these proposed changes ended on Oct. 2, 2019. Public comments received during the comment period can be read here. I know providers are interested in this regulation change; we will post again in a future newsletter when the change becomes final.
Emergency Room Behavioral Health Hold Extended
Providers were previously notified that Alaska Medicaid’s temporary expanded coverage for behavioral health observation bed services would end effective 01/01/2020. Coverage has now been extended through the end of SFY2020, terminating effective 07/01/2020. Reimbursement is limited to 120 hours per hold. Please see the Remittance Advice (RA) message for more information.