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Renee Gayhart
Director

Recipient Helpline

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Health Care Services

Our mission is to provide to all eligible Alaskans access and oversight to the full range of appropriate Medicaid services. We also protect Alaska’s most vulnerable populations through our certification and licensing sections.

You can read more about our Mission, Vision, and Core Values.

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News

    • DHCS Administrative Services
      As part of the ongoing evaluation of administrative contracts supporting the Medicaid Program, the Division of Health Care Services has not renewed the Explanation of Medical Benefits (EOMB) functionality, and telephone based case management services provided by MedExpert International. Providers and recipients previously utilizing the services of MedExpert are encouraged to contact the provider and recipient helplines at Conduent to discuss coverage options, request travel authorizations, and to review other services available to Medicaid recipients: (800) 770-5650.

      Recipients who would like additional information regarding case management services that may be available are encouraged to call Zayda Cooper at (907) 269-7383 or Jason Ball at (907) 334-2186.
    • 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.
    • Emergency Room Behavioral Health Hold Coverage Max 120 Hours will end on 12/31/19
      Effective January 1, 2020, Alaska Medicaid’s temporary expanded coverage for behavioral health observation bed services will end. As a result, Medicaid reimbursement for all observation services, including behavioral health, will be limited to 24 consecutive hours.

      For dates of service on or before December 31, 2019, Alaska Medicaid will continue to reimburse behavioral health observation bed for a maximum of 120 consecutive hours per episode. All hours must be billed on a single claim line with the appropriate diagnosis codes. If the submitted claim line exceeds 120 consecutive hours, the claim line will be cut back to 120 hours. If additional hours are billed on subsequent lines or a new claim for the same episode, the subsequent line or new claim will be denied.

      For dates on and after January 1, 2020, claims submitted for more than 24 hours will be reduced to the 24 hour limit.

      Questions? Please contact Sherri LaRue at sherri.larue@alaska.gov.
    • Golden Ticket Pilot Project Ending December 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 December 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 December 31, 2019. For dates of service on and after January 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 at brenda.vincent@alaska.gov or (907) 334-2430 or Jamie Walker at jamie.walker@alaska.gov or (907) 334-2406.
    • Enhanced Adult Dental Program – Temporary Coverage Extension
      The Department of Health and Social Services is extending coverage for adult enhanced (preventive and restorative) dental services through September 30, 2019. Medicaid recipients age 21 and older have been notified by mail. Providers have been notified via remittance advice message, the Medicaid program’s official mode of communication with providers. Medicaid recipients who require dental services should contact their dental provider. Dental services, if approved, must be scheduled or initiated on or before September 30, 2019, and must be completed by October 31, 2019. All previously denied dental service requests that were submitted on or after 07/01/2019 and were denied because the program was unfunded will be reconsidered. Coverage for dentures is not ending and therefore not subject to the October 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.
    • Opioid Training/CEU Opportunity for Prescribing Providers
      New Alaska legislation requires a minimum of two hours of continuing education in pain management, opioid use, and addiction for prescribing providers. For information on applicable courses, view the Opioid and Pain Management training flyers on the Enterprise Provider Messages and Announcements page.
    Proposed and Adopted/Filed Regulations

    Mission

    We provide to all eligible Alaskans access and oversight to the full range of appropriate Medicaid services. We also protect Alaska’s most vulnerable populations through our certification and licensing sections.

    Vision

    We will innovate health plans that improve quality of health care for all Alaskans, attract excellent providers, and be known for outstanding customer service.

    Core Values

    Through quality service, prudent use of resources, and satisfied, productive, employees we will promote good health for the people we serve, via ACCESS:

    • ARTICULATE

      Use skills and tools to clearly elicit and convey effective feedback, goals and guidance to all customers and team members.

    • COMPETENT

      Maintain the knowledge, skills and ability necessary to perform our jobs and treat everyone with dignity.

    • CONSTRUCTIVE

      Embrace evidence, data, and best practices to innovate and to improve everything we do; never accept “good enough,” or “that’s the way it’s always been done.”

    • ETHICAL

      Set an example of the ethical values of our division, department and state, recognize and respond to risks, respect and value each member of our team.

    • STRATEGIC

      Appropriately follow policies and procedures; model creativity and support to our team members by giving authority along with responsibility.

    • SINCERE

      Inspire our team members and customers through positive attitudes and by our consistency, fairness, and transparency.
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