Health Care Services highlights faster licensing, staffing gains and large tribal Medicaid recoveries
February 17, 2026 | 2026 Legislature Alaska, Alaska
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Martha Hewlett, administrative operations manager for Health Care Services, presented the division’s FY25–FY27 operating budget and highlighted several operational improvements to the House Finance Health Subcommittee on Feb. 17.
Hewlett said the division reduced residential licensing application times by about 48 calendar days (from roughly 160 to about 106 days) and cut provisional background check clearances to one business day. The division also reported a significant vacancy reduction—from roughly 30% in FY23 to about 8%—which officials credited to hiring activity rather than salary increases.
On recoveries and tribal 'reclaiming,' Deputy Commissioner Emily Ricci and Health Care Services staff explained that a Centers for Medicare and Medicaid Services state health official (SHO) letter issued around 2016–2017 enabled coordinated care agreements that can support a 100% federal match (FMAP) for certain services. The department said reclaiming work and other recoveries (including pharmacy rebates) contributed materially to Medicaid recoveries; Health Care Services reported roughly $616 million in tribal reclaiming savings over the past six years (presented as an approximate cumulative figure).
Representative Ruffridge asked how reclaiming interacts with prior federal/state matching and whether the state effectively receives duplicate federal funds. Ricci explained reclaiming credits back the state’s UGF share when documentation shows a claim is eligible for a full federal match rather than the state’s previous match portion.
The division also noted increased recoveries from third‑party liability and pharmacy rebates—Hewlett said pharmacy rebates accounted for about $140 million of a larger recoveries total reported for FY25.
What lawmakers requested: members asked for dates and a copy of the SHO letter and for clearer breakdowns of recoveries and regional grant distribution; the department agreed to follow up with documentation and publicly posted grant materials.
Sources: Testimony by Lynn Kamen Cruz (presented in session as director), Martha Hewlett, and Emily Ricci; Alaska House Finance Health Subcommittee meeting, Feb. 17, 2026.
Hewlett said the division reduced residential licensing application times by about 48 calendar days (from roughly 160 to about 106 days) and cut provisional background check clearances to one business day. The division also reported a significant vacancy reduction—from roughly 30% in FY23 to about 8%—which officials credited to hiring activity rather than salary increases.
On recoveries and tribal 'reclaiming,' Deputy Commissioner Emily Ricci and Health Care Services staff explained that a Centers for Medicare and Medicaid Services state health official (SHO) letter issued around 2016–2017 enabled coordinated care agreements that can support a 100% federal match (FMAP) for certain services. The department said reclaiming work and other recoveries (including pharmacy rebates) contributed materially to Medicaid recoveries; Health Care Services reported roughly $616 million in tribal reclaiming savings over the past six years (presented as an approximate cumulative figure).
Representative Ruffridge asked how reclaiming interacts with prior federal/state matching and whether the state effectively receives duplicate federal funds. Ricci explained reclaiming credits back the state’s UGF share when documentation shows a claim is eligible for a full federal match rather than the state’s previous match portion.
The division also noted increased recoveries from third‑party liability and pharmacy rebates—Hewlett said pharmacy rebates accounted for about $140 million of a larger recoveries total reported for FY25.
What lawmakers requested: members asked for dates and a copy of the SHO letter and for clearer breakdowns of recoveries and regional grant distribution; the department agreed to follow up with documentation and publicly posted grant materials.
Sources: Testimony by Lynn Kamen Cruz (presented in session as director), Martha Hewlett, and Emily Ricci; Alaska House Finance Health Subcommittee meeting, Feb. 17, 2026.
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