Briefs & Reports

Medicaid Policies

The Michigan Department of Health and Human Services (MDHHS) has issued six final and four proposed policies that merit mention. They are available for review on DCH’s website.

  • MSA 15-06 informs Home Help Agency and Individual Providers that the change in policy announced in MSA 14-58, then delayed, will now be implemented effective June 1, 2015. This policy modifies requirements for provider enrollment and verification of provided services. The initial release is attached to the latest policy bulletin.
  • MSA 15-07 clarifies for School Based Services Providers and Billing Agents department audit and recoupment policies.
  • MSA 15-08 advises Pharmacy Providers and Federally Qualified Health Centers that selected pharmacies may administer certain vaccines to adults and to children age 11 and older. Implementation of this policy is contingent upon federal State Plan Amendment approval.
  • MSA 15-10 notifies Bridges Eligibility Manual Holders of changes in certain asset requirements associated with Supplemental Security Income (SSI)-Related Medicaid eligibility.
  • MSA 15-13 advises Home Help Agency Providers, Prepaid Inpatient Health Plans and Community Mental Health Services Programs of changes in Home Help Agency Provider Standards.
  • MSA 15-17 informs Hospitals and Medicaid Health Plans that a new Short Hospital Stay reimbursement rate for certain outpatient and inpatient hospitals stays will be effective July 1, 2015. The bulletin includes the criteria to determine stays to which the new rate will apply.
  • A proposed policy (1522-DME) has been issued that would establish used equipment payment rates for 35 Durable Medical Equipment codes and set standards for the provision of used equipment to beneficiaries. Comments are due to MDHHS by June 24, 2015.
  • A proposed policy (1523-Supplies) has been issued that would change the policy published in MSA 14-44 on Coverage of Blood Glucose Testing Supplies because it was too restrictive. Comments are due to MDHHS by June 24, 2015.
  • A proposed policy (1526-DSH) has been issued that would implement an increase in the Outpatient Uncompensated Care DSH Pool and eliminate the Indigent Care Agreement DSH Pool. Comments are due to MDHHS by June 24, 2015.
  • A proposed policy (1527-Hospital) has been issued that would change the reimbursement methodology for State Psychiatric Hospitals from the current cost-settled structure to a cost-based prospective per diem structure. Comments are due to MDHHS by June 26, 2015.

MDHHS has also released five L-letters of potential interest, which are available for review on the same website.

  • L 15-31 was released on May 26, 2015 to individual Home Help providers to inform them of a change from paper logs to identify tasks provided to a requirement for recording service time through an Electronic Service Verification system in the Community Health Automated Medicaid Processing System (CHAMPS).
  • L 15-32 was released in late May to remind Nursing Facilities that changes in Medicaid-certified beds (increase, decrease or relocation) require State Medicaid Agency approval.
  • L 15-33 was released on May 27, 2015 as a notice of the department’s intent to submit a waiver amendment for the MI Choice program to the federal Centers for Medicare and Medicaid Services (CMS) in order to implement a conflict-free (independent) nursing facility level of care determination process by contracting, through a competitive procurement, with an entity to conduct the determinations. Currently the MI Choice waiver agencies conduct them. The amendment also updates MI Choice performance measures.

For more information, contact Esther Reagan, Senior Consultant, at (517) 482-9236.