Agency Action: Amendment to the Medicaid State Plan

The Department of Health (the department) hereby gives notice that it intends to seek approval from the Centers for Medicare and Medicaid Services (CMS) for a state plan amendment (SPA), with a July 1, 2026, effective date.

Subject of Amendment(s): The purpose of the proposed SPA is to update the effective dates of rates on the frontispiece (page 1) of Attachment 4.19-B to the most current fiscal year rate. Other updates will be made to rate descriptions to remove redundant language and refer to the frontispiece.

Services with inflationary adjustments

The rates listed on the frontispiece have an annual inflationary adjustment for services listed directly below, reflecting preplanned, percentage increases built into the stated rate descriptions.

1. Ambulatory surgical clinical services
   • The change reflects and annual inflationary adjustment of 3.1%
     • This results in an estimated increase of costs for SFY 2027 of $124,060 for federal funds and $57,822 for state funds.
2. In-home peritoneal service
   • The changes reflects a rebasing adjustment[CH1][MB2]
     • This results in an estimated increase of costs for SFY 2027 of $2,402 for federal funds and $1,411 for state funds.
3. Physician services
   • The change reflects the updated Medicare rates and revised conversion factor of 46.513.
   • This results in an estimated increase of costs for SFY 2027 of $2.5m for federal funds and $2.27m for state funds.
4. Licensed behavior analysts & Substance use rehabilitation services (combined with mental health clinic)
   • The change reflects an annual inflationary adjustment of 3.2%.
     • This results in an estimated increase in costs for SFY2027 of $196,535 for federal funds and $101,415 for state funds.
5. Personal care services
   • The change reflects an annual inflationary adjustment of 3.2%.
     • This results in an estimated increase of costs for SFY2027 of $360,118 federal funds and $315,830 state funds.
6. Personal care services for community first choice option
   • The change reflects an annual inflationary adjustment of 3.2%.
     • This results in an estimated increase of costs for SFY2027 of $430,343 federal funds and $259,333 state funds.
7. Chore services for community first choice option
   • The change reflects an annual inflationary adjustment of 3.2%.
     • This results in an estimated increase of costs for SFY2027 of $15,144 federal funds and $10,603 state funds.
8. Long-term services and supports (LTSS) Targeted Case Management
   • The change reflects an annual inflationary adjustment of 3.2%.
   • This results in an estimated increase of costs for SFY2026 of $93,718 federal funds and $50,119 state funds.

Language and Reference Clarification Updates

A. Ambulatory Surgical Clinic Services

1. The sentence “the fee schedule was last updated, to be effective for services on or after July 1, 2025” to “The rates are effective for services on or after the date listed on Attachment 4.19-B, page 1.”

B. Personal Care Services for Community First Choice Option

1. The sentence “Effective for services provided on or after July 1, 2025, providers of…” will be edited to “Providers of Personal Care Services for Community First Choice eligible recipients will be reimbursed at fee-for-service rates built on…” This change corrects the redundancy of the final sentence in the description stating, “The rates are effective for services on or after the date listed on Attachment 4.19-B, Page 1.”

C. Chore Services for Community First Choice Option

1. The sentence “Effective for services provided on or after July 1, 2025, the State Medicaid Program…” will be edited to “The State Medicaid program reimburses providers of Chore services…” This change corrects the redundancy of the final sentence in the description stating, “The rates are effective for services on or after the date listed on Attachment 4.19-B, Page 1.”
2. This results in an estimated increase in costs for SFY2026 of $16,136 federal funds and $8,125 state funds.

D. Justice Involved Youth (JIY) – Targeted Case Management

1. The sentence “The agency’s fee schedule was set as of January 1, 2025, and its effective date…” will be replaced with “The rates are effective for service on or after the date listed on Attachment 4.19-B.” This change will streamline the effective date references.

EPSDT and ARRA

The proposed amendments will not affect how Alaska Medicaid provides or reimburses Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) services.

Public Comments:

The department is holding a public comment period relative to these amendments until 5 PM on Thursday, July 30^th, 2026. Individuals may submit written comments via email to christal.hays@alaska.gov. Please submit electronic comments as an attached word document or text within the email body with the phrase “2026 Fee Schedule Updates” in the subject line. All submissions must include the sender’s full name and email address.

If you are a person with a disability who requires a special accommodation to participate in this process, please contact Christal Hays christal.hays@alaska.gov  or (907)891-4830 not later than Wednesday July 15, 2026, to ensure the provision of any necessary accommodations.

Individuals unable to submit comments by email should submit written comments by the close of the comment period to:

DOH Commissioner’s Office

c/o Christal Hays

3601 C Street, Suite 902

Anchorage, AK 99503