Medicaid State Plan
Alaska's agreement with the federal government to run the Medicaid program
Overview
This online version of the Medicaid State Plan, outlining Alaska’s agreement with the federal government for administering the Medicaid program as a service to Alaskans.
Please note, the information provided online is for informational purposes only and is not legally binding. The official Medicaid State Plan is maintained by the Alaska Department of Health Commissioner’s Office.
Please note: The contents below apply to the Alaska Medicaid program. Gaps in the numbering sequences occur when specific sections either do not apply to Alaska Medicaid or have been superseded by content in other areas of the state plan.
Medicaid State Plan
Section 1.0 – Single State Agency Organization
Section 1.0 – Single State Agency Organization
Section 2.0 – Coverage and Eligibility
Section 2.0 – Coverage and Eligibility
- MAGI Medicaid Eligibility
- MAGI (S-10) Methodology
- MAGI (S-21) Hospital Presumptive Eligibility
- MAGI (S-32) New Adult Group (Expansion Population)
- MAGI (S-88) State Residency
- MAGI (S-89) Citizenship and Non-Citizen Eligibility
- MAGI (S-94) Medicaid Eligibility Process
- Continuous Eligibility for Pregnant Women and Extended Postpartum Coverage
- 2.1 – Application, Determinations of Eligibility, and Furnishing Medicaid
- 2.2 – Coverage and Conditions of Eligibility
- 2.4 – Blindness
- 2.5 – Disability
- 2.6 – Financial Eligibility
- Attachment A – Eligibility Conditions and Requirements
- Supplement 1 – Income Eligibility Levels
- Supplement 2 – Categorically Needy Groups
- Supplement 3 – Reasonable Limits
- Supplement 4 – Treatment of Income Methods (different from SSI)
- Supplement 5 –Treatment of Resources
- Supplement 6 – Standards for Optional State Supplementary Payments
- Supplement 7 – Income Levels for 1904(f) States
- Supplement 8 – Resource Standards for 1904(f) States
- Supplement 9 – Transfer of Resources (Institutional)
- Supplement 10 – Trust & Hardship Provisions
- Supplement 11 – Cost-Effectiveness Methodology for COBRA
- Supplement 12 – Personal Needs Allowance & Transitional Medical Assistance
- Supplement 13 – Section 1924 Provisions
- Supplement 16 – Asset Verification System
- Supplement 17 – Disqualification for LTC Assistance (Substantial Home Equity)
- Supplement 18 – Methodology for Identifying FMAP Rates
- Attachment A – Eligibility Conditions and Requirements
- 2.7 – Medicaid Furnished Out of State
Section 3.0 – Services: General Provisions
Section 3.0 – Services: General Provisions
- 3.1 – Amount, Duration, and Scope of Services
- Attachment A – Amount, Duration, and Scope of Medical and Remedial Care and Services Provided to the Categorically Needy Groups
- Attachment B - Amount, Duration, and Scope of Medical and Remedial Care and Services Provided to the Medically Needy Groups
- Attachment C – Standards and Methods of Assuring High-Quality Care
- Attachment D – Methods of Assuring Transportation
- Attachment E – Standards for the Coverage of Organ Transplant Services
- Attachment K – Community First Choice
- Attachment L – Alternative Benefit Plan (Expansion Group)
- 3.2 – Coordination of Medicaid with Medicare Part B
- 3.3 – Medicaid for Individuals Aged 65 and Over in Institutions for Mental Diseases
- 3.4 – Special Requirements Applicable to Sterilization Procedures
- 3.5 – Medicaid for Medicare Cost-Sharing for Qualified Medicare Beneficiaries
Section 4.0 – Program Administration and Reimbursement
Section 4.0 – Program Administration and Reimbursement
- 4.1 – Methods of Administration
- 4.2 – Hearings for Applicants and Recipients
- 4.3 – Safeguarding Information on Applicants and Recipients
- 4.4 – Medicaid Quality Control
- 4.5 – Medicaid Agency Fraud Detection and Investigation Program
- 4.6 – Reports
- 4.7 – Maintenance of Records
- 4.8 – Availability of Agency Program Manuals
- 4.9 – Reporting Provider Payments to the Internal Revenue Service
- 4.10 – Free Choice of Providers
- 4.11 – Relations with Standard Setting and Survey Agencies
- 4.12 – Consultation with Medical Facilities
- 4.13 – Required Provider Agreement
- 4.14 – Utilization Control
- 4.15 – Inspections of Care in Skilled Nursing and Intermediate Care Facilities and Institutions for Mental Diseases
- 4.16 – Relations with State Health and Vocational Rehabilitation Agencies and Title V Grantees
- 4.17 – Liens and Recoveries
- 4.18 – Cost Sharing and Similar Charges
- 4.19 – Payment for Services
- Attachment A – Methods and Standards for Establishing Payment Rates – Inpatient Hospital Care
- Attachment B – Methods and Standards for Establishing Payment Rates – Other Types of Care
- Attachment C – Payments for Reserved Beds & Tribal Health System Reimbursement
- Attachment D – Methods and Standards for Establishing Payment Rates – Skilled Nursing and Intermediate Care Facility Services
- Attachment E – Timely Claims Payment – Definition of a Claim
- Attachment F – Federal Matching of Y2K-Related State Projected Payments to Medicaid and State Children’s Health Insurance Program Providers.
- 4.20 – Direct Payments to Certain Recipients for Physician or Dentist Services
- 4.21 – Prohibition Against Reassignment of Provider Claims
- 4.22 – Third-Party Liability
- 4.23 – Use of Contracts
- 4.24 – Standards for Payments for Skilled Nursing and Intermediate Care Facility Services
- 4.25 – Program for Licensing Administrators of Nursing Homes
- 4.26 – Drug Utilization Review Program
- 4.27 – Disclosure of Survey Information and Provider or Contractor Evaluation
- 4.28 – Appeals Process
- 4.29 – Conflict of Interest Provisions
- 4.30 – Exclusion of Providers and Suspension of Practitioners Convicted and Other Individuals
- 4.31 – Disclosure of Information by Providers and Fiscal Agents
- 4.33 – Medicaid Eligibility Cards for Homeless Individuals
- 4.34 – Systematic Alien Verification for Entitlements
- 4.35 – Remedies for Skilled Nursing and Intermediate Care Facilities that do not Meet Requirements of Participation
- Attachment A – Eligibility Conditions and Requirements; Enforcement of Compliance for Nursing Facilities
- Attachment B – Eligibility Conditions and Requirements; Enforcement of Compliance for Nursing Facilities: Termination of Provider Agreement
- Attachment C – Eligibility Conditions and Requirements; Enforcement of Compliance for Nursing Facilities: Temporary Management
- Attachment D – Eligibility Conditions and Requirements; Enforcement of Compliance for Nursing Facilities: Denial of Payment for New Admissions
- Attachment E – Eligibility Conditions and Requirements; Enforcement of Compliance for Nursing Facilities: Civil Monetary Penalty
- Attachment F – Eligibility Conditions and Requirements; Enforcement of Compliance for Nursing Facilities: State Monitoring
- Attachment G – Eligibility Conditions and Requirements; Enforcement of Compliance for Nursing Facilities: Transfer of Residents
- Attachment H – Eligibility Conditions and Requirements; Enforcement of Compliance for Nursing Facilities: Additional Remedies
- 4.36 – Required Coordination between Medicaid and WIC Programs
- 4.37 – Prescribed Drugs; Manufacturer Rebates
- 4.38 – Nurse Aide Training and Competency Evaluation for Nursing Facilities
- 4.39 – Preadmission Screening and Annual Resident Review in Nursing Facilities (PASARR)
- 4.42 – Employee Education about False Claims Recoveries
- 4.43 – Medicaid Integrity Program
- 4.44 – Medicaid Prohibition on Payments to Institutions or Entities located Outside of the United States
- 4.46 – Provider Screening and Enrollment
Section 5.0 – Personnel Administration
Section 5.0 – Personnel Administration
Section 6.0 – Financial Administration
Section 6.0 – Financial Administration
Section 7.0 – General and Time-Limited Provisions
Section 7.0 – General and Time-Limited Provisions
- 7.1 – Plan Amendments
- 7.2 – Nondiscrimination
- 7.4 – Public Health Emergency Amendments
- Attachment A – Rescission of Extension of dSPA Authority; HCBS Reimbursement
- Attachment B – Extension of dSPA Authority; HCBS Reimbursement & Pharmacy Dispensing Fees
- Attachment C - Extension of 1135 and dSPA authority; Medicaid fee-for-service prior/service authorization requirements for behavioral health services & pharmacy dispensing fees
- 7.7 – Time-Limited Provisions