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Alaska - Adult Companion Services — Licensing, Medicaid Enrollment and Startup Requirements

Last reviewed: 2026-09-09

In Alaska, Adult Companion Services are funded through the state's Home and Community-Based Services (HCBS) waivers, including the Alaskans Living Independently (ALI) and Adults with Physical and Developmental Disabilities (APDD) waivers. The service provides non-medical supervision and socialization to help adults remain safely in their communities. Providers must first obtain certification from the Department of Health, Division of Senior and Disabilities Services (SDS) Provider Certification & Compliance Unit before they can enroll as a Medicaid provider.

The most significant structural requirement for prospective providers is that they must achieve SDS Certification under 7 AAC 130.220 prior to Medicaid enrollment. This involves submitting a comprehensive application packet, including a detailed Operations Manual with specific policies and procedures, to the SDS Provider Certification & Compliance Unit. There are no closed networks or Certificate of Need requirements, but the dual-step process of certification followed by Medicaid enrollment is mandatory.

1. Service Definition and Scope

Adult Companion Services in Alaska provide non-medical care, supervision, and socialization to adults who need assistance to remain safely in the community. These services are designed to prevent institutionalization by offering companionship and support with daily activities.

The service is typically provided in the individual's home or community settings and does not include medical or nursing care. It is a key component of Alaska's HCBS waiver programs aimed at supporting independence.

2. Regulatory and Oversight Agencies

The primary regulatory body for HCBS waiver services in Alaska is the Department of Health, Division of Senior and Disabilities Services (SDS). The Provider Certification & Compliance Unit within SDS handles the certification of providers.

Medicaid enrollment and claims processing are managed through the Alaska Medicaid portal, operated by Gainwell Technologies.

3. Gatekeeping Prerequisites: Who Can Even Apply

Before applying for Medicaid enrollment, prospective providers must obtain SDS Certification under 7 AAC 130.220. This is a mandatory prerequisite for all HCBS waiver providers in Alaska.

There are no Certificate of Need (CON) requirements, closed networks, or mandatory managed care affiliations for this specific service. However, providers must have a valid State of Alaska business license and appropriate insurance coverage before applying for certification.

4. Licensure and Certification Requirements

Providers must submit the Cert-01 Waiver Services Provider Certification Application to the SDS Provider Certification & Compliance Unit. The application requires a comprehensive Operations Manual, including specific policies and procedures.

If the provider intends to operate a licensed assisted living home in conjunction with these services, they must also complete the separate licensing process through SDS.

5. Medicaid Provider Enrollment

Once SDS Certification is achieved, providers must enroll through the Alaska Medicaid portal (medicaidalaska.com). Enrollment can be as an Individual Provider (sole proprietor) or a Group Provider.

Providers must submit their SDS Certification letter, IRS W-9, and Alaska Business License during the enrollment process.

6. Staffing, Training and Background Checks

All staff providing direct care must pass a background check through the Alaska Background Check Program. Agencies must have a designated Program Administrator if required by the specific service conditions of participation.

Staff must complete SDS training on critical incident reporting and settings requirements. Agencies must maintain a training policy and procedure as part of their Operations Manual.

7. Documentation, Policies and Records

Providers must maintain an Operations Manual that includes policies on background checks, critical incident reporting, financial accountability, confidentiality, and employee evaluation.

Agencies must also submit a Quality Improvement Report (for renewals) that tracks grievances, critical incidents, medication errors, and consumer satisfaction.

8. Billing, Rates and Claims

Billing for Adult Companion Services is conducted through the Alaska Medicaid portal, a software program like Payerpath, or electronic billing systems like Therap.

Providers must ensure their financial systems comply with generally accepted accounting principles and 7 AAC 105.230 to ensure accurate claims for payment.

9. Approval Sequence and Timeline

The approval process begins with obtaining a State of Alaska business license and insurance. The provider then submits the Cert-01 application and Operations Manual to SDS for certification.

After SDS certification is granted, the provider applies for Medicaid enrollment through the portal. The entire process can take several months depending on the completeness of the application and SDS review times.

10. Common Denials and Survey Findings

Applications are frequently delayed or denied if the Operations Manual is incomplete or if policies do not meet SDS standards. Submitting unnecessary documents (like entire employee handbooks instead of specific policies) can also slow down the review.

Failure to maintain current insurance, business licenses, or background checks for staff are common compliance issues during reviews.

11. Key Contacts and Resources

Prospective providers should utilize the resources provided by the SDS Provider Certification & Compliance Unit, including the SDS Training Academy and approved forms page.

For Medicaid enrollment questions, providers can contact Gainwell Technologies.

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