Alaska
In Alaska:
- All Medicaid services are delivered entirely on a fee-for-service basis through the Alaska Division of Health Care Services (DHCS), which is responsible for program and policy development; and the Alaska Division of Public Assistance (DPA), which is responsible for determining eligibility. There were a total of 120,611 beneficiaries enrolled in Alaska Medicaid as of July 2011.
- Alaska provides basic EPSDT services to children on a fee-for-service basis. This includes all behavioral health, mental health, and dental services provided through the benefit.
- A home and community-based services waiver for children with complex medical conditions offers Medicaid services to medically fragile children
As of 2012, 96,693 individuals were eligible for EPSDT through Alaska’s Medicaid program. According to CMS data from 2012, Alaska achieved an EPSDT screening ratio of 49% and a participation ratio of 38%. 42,646 children received dental services of any kind, with 37,540 receiving preventive dental services.
Last updated June 2014.
| Medical Necessity |
Alaskan relies on the federal definition through state legislation defining EPSDT covered services as follows:
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| Initiatives to Improve Access |
Alaska is part of the Tri-State Child Health Improvement Consortium (T-CHIC), in which it is collaborating with Oregon and West Virginia as part of the Children’s Health Insurance Program Reauthorization Act (CHIPRA) Quality Demonstration Project. Through this project Alaska is working to develop medical homes for children enrolled in Alaska Medicaid and Denali Kid Care as a way to increase access to EPSDT services. |
| Reporting & Data Collection |
As part of Tri-State Child Health Improvement Consortium (T-CHIC), Alaska is requiring successful medical home pilots to address the following areas:
The participating medical homes also must comply with the CHIPRA Core Measures for voluntary use by Medicaid and CHIP programs.
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| Behavioral Health |
Behavioral and mental health services are covered on a fee-for-service basis as deemed medically necessary.
As described in Alaska’s Integrated Behavioral Health Regulations, Medicaid-covered behavioral health services for children include therapeutic behavioral health services and day treatment services for children.
The state’s EPSDT provider billing manual encourages developmental screenings and assessments. The Alaska Department of Health and Social Services recommends a number of developmental screening tools, including the Ages and Stages Questionnaire, the Battelle Developmental Inventory Screening Tool, and Parents’ Evaluation of Developmental Status.
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| Support to Providers and Families |
Support to Families
Alaska relies on mailings and newsletters to inform families about the EPSDT benefit.
Support to Providers
Alaska contracts with Xerox State Healthcare LLC, which maintains the Alaska Medical Assistance Health Enterprise Portal to support providers.
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| Care Coordination |
Alaska, through its contractor Qualis Health, provides case management services designed for patients with serious illness, injuries, and some chronic conditions. These services are available to children with disabilities and children covered by Alaska’s Children with Complex Medical Conditions Waiver. Upon receiving a referral for case management services, a Qualis Health nurse manager works with the patient and family on a number of things related to health care needs including working with the patient, family and medical providers to develop a coordinated care plan. Additionally, these managers also help coordinate the services provided by all professionals involved.
The coordination of EPSDT services – including dental, behavioral, and other need – for Medicaid children is also a primary goal of the practices participating in the T-CHIC initiative.
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| Oral Health |
Alaska Medicaid covers all dental services for children on a fee-for-service basis. This includes exams, X-rays, scaling, polishing, sealants, and fluoride varnish (physicians may apply fluoride varnish in Alaska). Alaska also covers dentures, crowns, caps, root canals and oral surgery, though some may require prior authorization. Alaska also covers orthodontia services, including braces, if deemed medically necessary and prior authorization is obtained. |
For individuals living with complex, often chronic conditions, and their families, palliative care can provide relief from symptoms, improve satisfaction and outcomes, and help address critical mental and spiritual needs during difficult times. Now more than ever, there is growing recognition of the importance of palliative care services for individuals with serious illness, such as advance care planning, pain and symptom management, care coordination, and team-based, multi-disciplinary support. These services can help patients and families cope with the symptoms and stressors of disease, better anticipate and avoid crises, and reduce unnecessary and/or unwanted care. While this model is grounded in evidence that demonstrates improved quality of life, better outcomes, and reduced cost for patients, only a fraction of individuals who could benefit from palliative care receive it. 
