1) State: Alaska
2) Own or Federal Exchange? Federal Exchange
Source: http://www.medicaid.gov/Medicaid-CHIP-Program-Information/By-State/alaska.html
3) Medicaid Expansion? No
Source: http://www.medicaid.gov/Medicaid-CHIP-Program-Information/By-State/alaska.html
4) What kind of coverage is available for mental health/substance abuse treatment through
Medicaid?
Covered Community Behavioral Health Services:
• Screening Services to determine the presence and severity of behavioral health disorders
• Clinic Services, including assessments, psychotherapy (individual, group, family), psychological testing,
medications management, and crisis intervention services
• Rehabilitation Services, including assessments, case management, medication administration,
therapeutic behavioral health services for children, comprehensive community support services for
adults, day treatment services for children in a school setting, recipient support services to support
those at risk of harm to self or others, substance use disorder treatment (outpatient, detoxification,
residential treatment), and peer support
Eligibility for Community Behavioral Health Services
• Screening Services are available for all Medicaid recipients
• Clinic Services are covered for Medicaid recipients who meet the following criteria:
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an adult or child experiencing an emotional disturbance
a child experiencing a severe emotional disturbance
an adult experiencing a chronic mental illness
an adult or child experiencing a substance use disorder
• Rehabilitation Services are available for Medicaid recipients who meet the following criteria:
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a child experiencing a severe emotional disturbance
an adult experiencing a chronic mental illness
an adult or child experiencing a substance use disorder
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Community behavioral health services are provided only within the state. If needed services are
not available in the community, it may be necessary to travel to another location in Alaska to
meet the needs of the patient. In these cases, the provider will contact the state to request
authorization of travel outside the patient’s home community.
Source: http://dhss.alaska.gov/dhcs/Documents/PDF/Recipient-Handbook.pdf
5) Does the state allow the court to order treatment and still have it paid by Medicaid?
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The court can order treatment and have it paid by Medicaid if the services are covered by
Medicaid (shown in the question above).
6) Are there restrictions related to treatment providers for probationers, substance abuse, or mental
health treatment? Will only certain providers be covered?
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The Alaska Division of Behavioral Health provides a continuum of statewide behavioral health
(mental health and substance use) services ranging from prevention, screening, and brief
intervention to acute psychiatric care.
Treatment providers must be contracted with the Alaska Division of Behavioral Health and must
have the appropriate license and certification to treat patients in Alaska.
Source: http://dhss.alaska.gov/dbh/Pages/coreservices/default.aspx
7) Is there coverage for residential substance abuse treatment? What are the parameters?
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There is coverage for residential substance abuse treatment through Alaska Medicaid. Alaska
Medicaid requires prior authorization of all psychiatric admissions and continued stays at both
in-state and out-of-state facilities. A diagnostic evaluation, a certification of need for inpatient
psychiatric services, and a plan of care must be completed by an inpatient interdisciplinary team
and submitted to Alaska Medicaid for review.
Inpatient Psychiatric Hospital Services — coverage is limited to people with acute psychiatric
needs who are either under the age of 21 or over the age of 65.
General Inpatient Hospital —coverage is available to all eligible recipients with acute psychiatric
needs.
Residential Psychiatric Treatment Centers (RPTC) — coverage is limited to people up to age 21.
RPTCs provide residential care and treatment of mental, emotional, or behavioral disorders.
Source: http://dhss.alaska.gov/dhcs/Documents/PDF/Recipient-Handbook.pdf
http://store.samhsa.gov/shin/content/NMH05-0202/NMH05-0202-AK.pdf
8) What is the process and what are the regulations for treatment providers to be able to participate?
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Providers must be licensed or certified to practice in the state of Alaska. They also must be
Alaska Medicaid Certified to receive reimbursements.
Medicaid reimbursement is available for mental and behavioral health services covered under
various service categories: physician services, inpatient and outpatient hospital services,
licensed practitioner’s services, clinics, and rehabilitative services.
Source: http://www.medicaid.gov/Medicaid-CHIP-Program-Information/By-Topics/Benefits/MentalHealth-Services-.html
9) Is dental care covered?
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Dental care is an option in the Marketplace, but is not included in the basic plan (except for
children).
Alaska’s Medicaid for adults covers $1,150 worth of preventive dental care each year for
Alaskans 21 and older who receive Medicaid services. This care includes exams, cleanings,
fillings, root canals, and dentures.
Source: http://dhss.alaska.gov/dhcs/Pages/medicaid_medicare/dental_medicaid/default.aspx