Office of Rate Review

Resources and Reports

Statutes and Regulations

Welfare, Social Services and Institutions Statute

AS 47.05 Administration of Welfare, Social Services and Institutions

Medical Assistance for Needy Persons Statute and Regulations

Certificate of Need Program Statute and Regulation

Supplemental Emergency Medical Transportation Program Statute and Regulations

Medicaid State Plan

Section 4.19 Payment for Services

Attachments and Supplements for Section 4.19:

Attachment A: Methods and Standards for Establishing Payment Rate - Inpatient Hospital Care (Hospitals and RPTCs)
Attachment B: Methods and Standards for Establishing Payment Rates - Other Types of Care

Supplement 1 to Attachment B

Attachment A to Attachment 4.19D

Medicaid Access Monitoring Review Plan

On October 29, 2015, the Centers for Medicare and Medicaid Services (CMS) issued a new rule requiring state Medicaid programs to develop and implement Access Monitoring Review Plans (AMRP). Plans must use data analytics to monitor recipient access to certain Medicaid services, and the effect of changes in Medicaid reimbursement rates on access to those services.

Medicaid Quality & Cost Effectiveness Target

In 2016, the Legislature passed Senate Bill 74 (SB74). Section 43 of SB74 adds AS 47.05.270 to the Medicaid statutes, creating the Medical Assistance Reform Program, also known as the Medicaid Reform Program. The purpose is to improve health outcomes and the quality, performance, and cost effectiveness of Alaska’s Medicaid Program. One of the requirements in SB74 directs the Department with stakeholder involvement to set annual quality and cost effectiveness targets and another requires the department to report on whether the annual targets have been met.

The Department convened the initial Medicaid Redesign Quality and Cost Effectiveness Targets Stakeholder Workgroup (Q&CE) October 2016 through August 1, 2017, to develop recommendations on measures the Department could use to evaluate and monitor the overall quality of the Medicaid program and help determine the cost effectiveness of program expenditures.

The Alaska Medicaid Redesign Quality and Cost Effectiveness Targets Report, August 2017, transmits the workgroup’s measure and target recommendations to the Department.

Information in these reports, applicable to state fiscal year, is used to inform the annual Medicaid Reform Report submitted to the Legislature on or before November 15. For more information see Healthy Alaska Medicaid Redesign.