Provider guidance for Alaska Medicaid fiscal agent transition and operational updates
Customize your policy alerts
Sign up for all Alaska Medicaid policy alerts
Know when Alaska Medicaid releases new policies or updates existing guidance.
Monitor payer policy activity
Governs operational updates for Alaska Medicaid providers related to the MMIS fiscal agent transition, including new service authorization (SA) requirements for physician-administered drugs (PAD), claim/adjustment guidance, appeals process reminders, DSM use, and provider training; affects Alaska Medicaid providers and billing staff.
Service Authorization requirements for specific Physician-Administered Drugs (PAD) are going into effect as of April 1, 2024.
Medicaid Payment Rates, FQHC Productivity, and Rate Setting regulations filed 01/17/24 effective 02/16/24; Advanced Practice Dental Hygienist/Dental Specialist regulations filed 01/31/2024 effective 03/31/2024.
Direct Secure Messaging (DSM) is available for secure submission of SA and enrollment documents; providers may obtain DSM accounts through HealtheConnect Alaska for a $75 annual fee.
Coverage and Submission Criteria
inv-01: Physician-Administered Drugs (PAD) coverage and authorization
Covered when ALL of the following are met:
inv-02: DSM submission and related processes
Accepted methods and requirements for transmitting documentation containing PHI/PII to the Fiscal Agent:
Coding, Timely Filing, and Example Codes
| J0172 | Aduhelm (example mapping listed) |
| J1426 | Amondys 45 (example mapping listed) |
Provider Actions, Authorizations, and Secure Submissions
PAD Service Authorization and Provider Training
Service authorizations are required for specific Physician-Administered Drugs (PAD) effective April 1, 2024. Providers must request PAD SAs through HMS using the SA request form submitted by fax or Direct Secure Messaging (DSM). PADs administered in a provider office or clinic must be billed through the medical benefit using the standard buy-and-bill process. Provider training on PAD SA requirements is offered Feb 20–Apr 5, 2024; register via the Learning Management Site.
- SA requirements effective April 1, 2024
- Submit SA requests to HMS via the PAD SA form by fax or DSM
- Bill office-administered PADs through medical benefit (buy-and-bill)
- Provider training sessions Feb 20–Apr 5; register on Learning Management Site
Submitting documentation via DSM to Fiscal Agent
Once you have a DSM account, send Provider Enrollment documents and Service Authorization requests to the Fiscal Agent using the designated Fiscal Agent DSM email addresses. The Fiscal Agent provides separate DSM addresses for Provider Enrollment and for General, Travel, Dental, and DME Service Authorization submissions.
- Obtain a DSM account (HealtheConnect Alaska) and use your DSM email to send documents to the Fiscal Agent
- Provider Enrollment: ProviderEnrollment@hms.fa.directak.net
- General SA: ServiceAuthorization@hms.fa.directak.net; Travel SA: TransportationSA@hms.fa.directak.net
- Dental SA: DentalSA@hms.fa.directak.net; DME SA: DMESA@hms.fa.directak.net
Security requirement for PHI/PII
Do not send PHI or PII via regular email—anything containing PHI/PII must be transmitted securely per HIPAA (for example, via DSM). Mailing or faxing remain acceptable alternatives if you prefer not to use DSM.
- Regular email is not secure enough for PHI/PII
- Use DSM (HIPAA-compliant) to transmit PHI/PII; DSM accounts available via HealtheConnect Alaska
- If you choose not to use DSM, you may continue to mail or fax documents
Key Definitions
OpenPayer is powered by Trek Health's payer performance platform. Trek continuously ingests, validates, and normalizes Transparency in Coverage data alongside payer policies and other commercial payer data to create a structured payer intelligence foundation. OpenPayer uses this foundation to deliver personalized search results, dynamically generated policy pages, and tailored policy monitoring based on each user's payers, specialties, billing codes, and areas of interest. The same intelligence powers broader payer performance workflows, including reimbursement benchmarking, contract evaluation, payer negotiations, and financial decision-making.