Agency Action: Amendment to the Medicaid State Plan
Pursuant to 42 CFR §§ 440.386 and 447.205, notice is hereby given that the Department of Health (the department) intends to seek approval from the Centers for Medicare and Medicaid Services (CMS) for amendments to the Alternative Benefit Plan (ABP) authorized under § 1937 of the Social Security Act for individuals 19 to 64 years of age who are eligible pursuant to § 1902(a)(10)(A)((i)(VIII) of the Social Security Act – the expansion population – and the Title XIX Medicaid State Plan.
Subject of Amendment(s):
The department intends to submit a state plan amendment (SPA) to adjust the reimbursement amount for in-state tribal and non-tribal professional pharmacy dispensing fees, effective upon the forthcoming, associated regulation effective date.
These proposed dispensing fees are anticipated to be temporary, providing the department time to enact regulations with updated dispensing fees determined by an ongoing pharmacy dispensing costs survey.
The proposed dispensing fees, to be reimbursed no more than once every 22 days per individual medication strength, are as follows:
- non-tribal pharmacies located on the road system: $15.03
- non-tribal pharmacies not located on the road system: $26.94
- tribal pharmacies: $28.21
Additionally, proposed amendment includes 1) the addition of the “tribal pharmacy” definition; 2) clarification that the mediset dispensing fee is reimbursed no more than once every 14 days per individual medication strength.
EPSDT and ARRA/Tribal Consultation:
The proposed amendments will not affect how Alaska Medicaid provides or reimburses Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) services. The department followed the tribal consultation process established under the American Recovery and Reinvestment Act (ARRA) of 2009 and set forth in its approved state plan.
Public Comments:
The department is holding a public comment period relative to these amendments until 5 PM on May 27, 2024. Individuals may submit written comments via email to emily.beaulieu@alaska.gov. Please submit electronic comments as an attached word document or text within the email body with the phrase “pharmacy dispensing fees” 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 Emily Beaulieu at Emily.beaulieu@alaska.gov or (907)538-7665 not later than May 12, 2024, 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 Emily Beaulieu
3601 C Street, Suite 902
Anchorage, AK 99503