Michigan made the change by adding three paragraphs to the states 2,060page medicaid provider manual, affirming that the state medicaid program doesnt discriminate and referring to the nondiscrimination provision of the 2010 affordable care act. Medicaid nursing facility payment policy landscapes. Medicaid expansion in michigan 3 implement the new healthy behavior requirements for nonmedically frail beneficiaries with incomes above 100% fpl as of april 2018. Guidelines for medicaid programs generally require applicants to be classified as lowincome or verylow income. The manual is regularly updated to reflect the most recent policy and procedure changes. The qualifications needed for the program are strict and there are a set amount of guidelines that must be followed in order to participate in the program. During the transition to the new manual, some policy information will still be available in the policy manuals and ats. Medicaid in michigan under the affordable care act.
Revision date 6 2014 all previous versions are obsolete 3 program overview the michigan dental program mdp is a comprehensive dental access program for persons living with hivaids, funded under title ii of the federal ryan white care act. Criminal history checks of michigan medicaid home help providers. Stay ahead of policy changes, check michigan telemedicine information. Pihps prepaid inpatient health plans are the regional mental health agencies in michigan. As of october 1, 2011, clients must be assessed as having a functional need of 3 or higher. Healthy michigan plan chronic condition copay exemption change. Michigan complete health follows cms rules and regulations for billing and reimbursement. The regulations enhance the quality of hcbs and provide additional protections to individuals that receive services under these medicaid authorities. Stephen fitton, director of michigan medicaid services administration, from the department of health and human services centers for medicare and medicaid services. Introduction this chapter introduces the format of the maryland medical assistance program the program or ma physicians services provider fee manual and tells the reader how to use manual. Changes to coverage of blood glucose testing supplies.
Michigan department of human services information packet, june 20, and michigan department of human services program descriptions fy 2015, january 2014, provided by the department of human services. The final home and communitybased services hcbs regulations set forth new requirements for several medicaid authorities under which states may provide home and communitybased longterm services and supports. Data is based on publicly available policy documentation identified in march, april, may of 2014. Despite these advances, michigan still only offers reimbursement for livevideo telemedicine services. The following documents comprise the michigan medicaid provider manual and. The medicaid provider manual contains participation coverage and reimbursement policies related to medicaid, healthy michigan plan, childrens special health. Only a few michigan nursing homes do not have medicaid certified beds. The office of child support is in the process of moving all policy from the policy manuals and action transmittals ats to the new michigan ivd child support manual.
Under the demonstration, michigan and cms will contract with health plans called integrated care organizations icos, which will provide an integrated. Cms publishes the state medicaid manual as guidance to the states on. Please identify the project number of the proposed medicaid policy or consultation summary if known. Increase of beneficiary copayment for nonemergency visits to the hospital emergency room. Disabled adult children michigan department of health. Jun 16, 2015 states change medicaid coverage of adult dental benefits on a regular basis, cutting benefits 2014, michigan dch 2014, minnesota dhs 2014, miss. Oct 03, 2014 this if from the michigan medicaid provider manual and applies to all medicaid services for people with developmental and other disabilities. Michigan medical necessity criteria for all medicaid dd. Michigan has also had a telehealth parity law since 2012, requiring coverage by private insurance.
The average monthly caseload in fy 201112 and fy 2012 stems from the policy change. Services currently available under michigan s state plan and medicaid waivers for adults and children with disabilities and mental illness. Ten rules for a successful medicaid application in michigan. These documents inform providers of changes in michigan medicaid policy. Medicaid in michigan under the affordable care act effective january 1, 2014 this is a general overview of the basics. Blue cross complete of michigan is a managed care health plan contracted by the state of michigan. Have authority to apply for the nursing home resident. See west virginia medicaid provider manual, ch 100 since at. Medicaid is the single largest health insurer for children. Adult services policy manual, february 3, 2014, provided by the department of human services. In quiet decision, michigan continues medicaid coverage of. Prior authorization by the medical director for bariatric surgery.
The medicaid law jim schuster certified elder law attorney. Occupational therapy student supervision guidelines guidelines specified based on clinical setting. Jan 06, 2020 michigan implemented its version of medicaid expansion in april 2014, and more than 651,000 people are enrolled. When seeking information about medicaid, potential applicants quickly discover that medicaid is medical assistance program designed to give lowincome households access to affordable health care. Michigan ar ournal may 2014 probate and estate planning medicaid estate recovery update allowed the recipient to live at home, or a sibling with an equity interest in the home who resided there for at least one year imme diately before the nursing facility admission. Bridges policy bulletin log michigan department of health. Experiences teaches that nursing homes offering medicaid certified beds are no different from any other. Michigan medicaid update michigan public health institute. It is also the primary source of health care for lowincome parents and other nonelderly adults, the elderly and people with disabilities.
The texas medicaid provider procedures manual is the providers principal source of information about texas medicaid. Services currently available under michigans state plan and medicaid waivers for adults and children with disabilities and mental illness. The asset eligibility test requires that eligibility be met for at least one day in the month being tested. Followup contact was made with state medicaid employees primarily policy staff to clarify policies which could not be found or were unclear. Michigan medicaid benefits eligibility guidelines vary according to each specific medicaid program. Michigan implemented its version of medicaid expansion in april 2014, and more than 651,000 people are enrolled. Michigan complete health medicare medicaid plan mmp provider billing manual mmp. Michigan medicaid approved policy bulletins the michigan department of health and human services periodically issues notices of policy.
We help medicaid members get the health care they need in 32 michigan counties across the state. The site provides information on the medicaid promoting interoperability pi program and its benefits to michigan providers and hospitals. Dec 1, 2015 medicaid, healthy michigan plan, childrens special health care use the michigan medicaid provider manual on the mdhhs website. A federal government website managed and paid for by the u. Disabled adult children michigan department of health and. Updates are generally available the month following the effective date of the change.
Addition of early and periodic screening, diagnosis and treatment chapter to the medicaid provider manual. These beneficiaries will have a one year grace period. In order for states like michigan to participate in the medicaid program, the federal government requires the states to adhere to. Medicaid is a program that helps these individuals get the coverage that they need. The michigan health it website is a resource for health care professionals, hospitals, payers, provider association groups, and patients. Enrollment, eligibility and disenrollment molina health care. Medicaid estate recovery update state bar of michigan. Current mdhhs policy manuals mdhhs michigan department of. The electronic medicaid provider manual contains coverage, billing, and reimbursement policies for medicaid, healthy michigan plan, childrens special health care services, maternity outpatient medical services moms, and other healthcare programs administered by the michigan department of health and human services mdhhs. Durable medical equipment dme providers, physicians, hospitals, medicaid health plans mhp issued. Meridian medicaid provider manual 2020 michigan revised 12020 8 make recommendations regarding the member rights and responsibilities policies members have the responsibility to. Bridges policy bulletin log michigan department of. When there is a conflict between these sources on a given. Michigan complete health medicaremedicaid plan mmp provider billing manual mmp 2 p a g e.
Only substandard nursing homes participate in medicaid. Pcpsspecialists should use the molina healthcare service request form or the michigan healthcare referral form. On april 1, 2014, michigan expanded its medicaid program to include adults. The indiana health coverage program policy manual ihcppm is an integrated eligibility manual that contains information about health coverage under medicaid, hoosier healthwise, hoosier care connect, and the healthy indiana plan. Community mental health services in michigan january 2014 house fiscal agency. Unitedhealthcare community plan of michigan healthy michigan plan. Jun 16, 2015 medicaid programs are required to cover dental services for children and youth under age 2014, michigan dch 2014, minnesota dhs 2014, miss. Molina healthcare of michigan medicaid provider manual. Requests must be made through your management or central specialized staff include titles. The state has implemented a work requirement for the medicaid expansion population, but a lawsuit has been filed to block it. To view our rapid dispute process for noncontracted hospitals providing services to unitedhealthcare community plan medicaid member, visit.
Health coverage options for noncitizens in michigan. Medicaid policy activity 2014 rate increase for obstetrical services msa 1432. The michigan department of health and human services mdhhs contains participation coverage, billing, and reimbursement policies for medicaid. Medicaid coverage for transitionrelated care no updates required since november 21, 2019. Total medicaid enrollees viii group break out report reported on the cms64 the enrollment information is a statereported count of unduplicated individuals enrolled in the states medicaid program at any time during each month in the quarterly reporting period. Michigan cms centers for medicare and medicaid services. In 2014, the state recently decided to remove distance restrictions as an eligibility requirement for patients to receive virtual care. The national drug codes for the 20142015 flu season will be coded to pay at. Michigan medical necessity criteria for all medicaid dd services.
For medicaid medicaid expansion plan members, this policy will apply. Check out evisit for important laws, regulations, and medicaid policies. This requirement means that even if the client becomes eligible for benefits only on the very last day of the month, the client is entitled to medicaid benefits for the entire month. Medicaid nursing facility payment policy landscapes michigan note. The home help program is the largest medicaid longterm care program in michigan, with. Physicians services provider fee manual medicaid home. Chapter 1 general zip chapter 2 state organization zip. We provide members with the care they need, when they need it.
Medicaid expansion in michigan kaiser family foundation. Oig oversees all state medicaid fraud control units mfcus or units with respect to federal grant compliance. The enrollment data identifies the total number of medicaid enrollees and, for states that have expanded medicaid, provides. The program expanded its coverage january 2014 with the affordable care act so even more residents are eligible to receive medical assistance.
Dental health is an important part of peoples overall health. To control prescription drug costs to the michigan medicaid program, effective april 1. Home health care page 16 o medicaid covers ot services when provided by. State notes summer 2014 overview of the medicaid adult. Supply information, to the extent possible, that the organization and its practitioners and. The michigan legislature website is a free service of the legislative internet technology team in cooperation with the michigan legislative council, the michigan house of representatives, and the michigan senate. In 2014, the state recently decided to remove distance restrictions as an eligibility. Introduction physicians services provider fee manual maryland medicaid 11 introduction to the fee manual. Intends to remain in michigan permanently or indefinitely. Medicaid nursing facility payment policy landscapes michigan. Unless you have a power of attorney that authorizes application for government benefits you may need to petition the probate court to be appointed the residents guardian and conservator.
Upper midwest telehealth resource center michigan medicaid provider manual. The enrollment data identifies the total number of medicaid enrollees and, for states that have expanded medicaid. Current mdhhs policy manuals michigan department of. Unitedhealthcare dual complete view the unitedhealthcare community plan of michigan care provider manual. Community plan care provider manuals for medicaid plans by. The regulations enhance the quality of hcbs and provide additional protections to individuals that receive services under these. Hab habilitation supports waiver for people with developmental disabilities sed children with serious emotional disturbances waiver state plan michigan s medicaid state plan services. States are required to provide dental benefits to children covered by medicaid and the childrens health insurance program chip, but states choose whether to provide dental benefits for adults. Hab habilitation supports waiver for people with developmental disabilities sed children with serious emotional disturbances waiver state plan michigans medicaid state plan services. Estate recovery and liens home equity limit the state medicaid program will not cover longterm care services for those with home equity above this limit, with certain exceptions. Is living in michigan, except for a temporary absence. Michigan medical necessity criteria for all medicaid dd services update. Mar, 2017 michigan medicaid provider manual on the mdch website.
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