MedicaidPrior AuthHigh impact
February 2024 Town Hall Presentation
Alaska Medicaid·AK · Oncology, Rheumatology, Neurology +3 more·Program Update
Effective date
Apr 1, 2024
We identified it
Jun 21, 2026
Summary
Alaska Medicaid is implementing new prior authorization requirements for 39 specific physician-administered drugs (PADs) including high-cost biologics and specialty medications effective April 1, 2024. Service authorizations must be requested through HMS fiscal agent via form submission through fax or new Direct Secure Messaging (DSM) system.
Action Required
By April 1, 2024: Billing team must implement prior authorization requirements for 39 specific physician-administered drugs. Update billing system to flag these HCPCS codes for required service authorization before administration. Obtain authorization forms from medicaidalaska.com and establish process to submit via fax or Direct Secure Messaging (DSM). Train providers on buy-and-bill process requirements. Claims will be denied without proper prior authorization.