The Medical Services Division administers Title XIX (Medicaid) and Title XXI (CHIP) for all North Dakotans. Policy priorities for the Division include:

  • Transition from paying for volume to paying for quality
  • Unwinding of the federal Public Health Emergency
  • Diversion and transition of individuals from institutional care to home and community-based care

Operational priorities include:

  • Modernizing the Medicaid Enterprise technology system
  • Streamlining operations of the call center, provider enrollment, and utilization management
  • Improving infrastructure for home and community-based providers
  • Focusing on data analytics particularly quality measures

Key Functions

The Medical Services Division has two primary functions: to act as a payer and to act as a program administrator. As a payer, the Medical Services Division operates like a health insurance organization. This includes provider enrollment, claim adjudication and payment, clinical management, and program integrity. As a program administrator, the Division designs, implements, and evaluates programs for targeted populations and services. Examples of these programs include Home and Community Based Waivers for the aged and disabled, Medicaid expansion for adults, the Early, Periodic, Screening, Diagnostic, and Treatment program for children, and Value Based Purchasing Programs.


Sarah Aker

Executive Director Medical Services

As the Executive Director of the Medical Services Division, Sarah oversees the ND Medicaid program, including Title XIX and Title XXI programs and services. Prior to joining HHS, Sarah served as the Medicaid director and various leadership roles in Medicaid and nonprofit health advocacy organizations in South Dakota. Sarah holds a bachelors degree in political science and chemistry from the University of South Dakota.