Medicaid Program Integrity

Who we are

Medicaid Program Integrity provides oversight of Medicaid. It focuses on prevention, investigation, education, audits, recovering improper payments, and works with Medicaid Fraud Control Units (MFCU).

What we do

• Encourage compliance
• Maintain accountability
• Protect public funds
• Support awareness and responsibility
• Ensure that providers meet participation requirements
• Ensure that services are medically necessary
• Ensure payments are for the correct amount and for covered services

Resources

​​Alaska Excluded Provider List

The Alaska Department of Health’s Program Integrity Unit maintains an up-to-date list of excluded providers whose Medicaid agreements were terminated due to fraud. This list is regularly updated as providers are added or removed.

An "excluded provider" is one who has been sanctioned and terminated by the State or Federal government, often for medical assistance fraud. Providers convicted of such offenses are not able to participate in the Medicaid program.

Medicaid providers and applicants should routinely check the Excluded Provider List and the List of Excluded Individuals/Entities (LEIE) to ensure that none of their employees or contractors are on the list.

Current Alaska Excluded provider list

Applying for reinstatement

Excluded providers who wish to participate in the Medicaid program after the period of exclusion ends must apply for reinstatement and receive official notice from Medicaid Program Integrity that their request has been approved.

To apply for reinstatement in the Medicaid program, follow these steps based on the reason for your exclusion:

General reinstatement requests

Send a written request to:
Department of Health
Medicaid Program Integrity
3601 C Street, Suite 902
Anchorage, AK 99503

Your request must include clear and convincing evidence that you hold all necessary licenses and certifications and are qualified to participate in Medicaid.

Reinstatement after convictions

If your exclusion was due to a conviction for medical assistance fraud or misconduct involving a controlled substance, the commissioner of the Department of Health may exclude you for up to 10 years following the unconditional discharge of the conviction.

In accordance with Alaska Statute 47.05.240, you may not participate in the Medicaid program until you prove to the commissioner, with clear and convincing evidence, that you possess all required credentials and are qualified to participate.

For such cases, send your request to:
Department of Health
Office of the Commissioner
Attention: Provider Exclusion Reinstatements
3601 C Street, Suite 902
Anchorage, AK 99503