MedicaidAdministrativeHigh impact
July Town Hall FAQ
Alaska Medicaid·AK · Psychiatry·Program Update
We identified it
Sep 4, 2026
Summary
Alaska Medicaid clarifies Third Party Liability (TPL) billing procedures for providers ineligible for Medicare enrollment, particularly behavioral health providers. Providers unable to enroll in Medicare must now submit proof of ineligibility with claims using attachment code 'EB' on the 837 form and include the Attachment Cover Sheet. Claims for dual-eligible recipients must bill Medicare first; Medicaid pays as secondary only after Medicare processes the claim and issues an EOB.
Action Required
Immediately: Billing team must update TPL claim submission procedures for Alaska Medicaid: (1) For providers unable to enroll in Medicare, obtain and retain proof of ineligibility; (2) Attach proof of ineligibility to all claims using attachment code 'EB' on the 837 electronic claim form, along with the Attachment Cover Sheet (available at https://extranet-sp.dhss.alaska.gov/hcs/medicaidalaska/Provider/Provider_Forms); (3) For dual-eligible recipients, configure billing system to bill Medicare first and wait for EOB before submitting to Medicaid as secondary payer; (4) Train billing staff on MMIS TPL processes per the September 17, 2024 guidance document referenced in the policy; (5) Attend HMS TPL training session if available. Billing team must implement these changes to prevent TPL-related claim denials. Reference MLN 1986542 for covered behavioral health services and eligible provider types.