The Michigan Department of Health and Human Services (MDHHS) is launching a new approach to mental health care under Medicaid as part of its MIHealthyLife initiative.
The “Mental Health Framework” is designed to make care more person-centered and better coordinated by clearly outlining whether a Medicaid Health Plan or a Prepaid Inpatient Health Plan is responsible for an individual’s care, based on their level of mental health need.
To support implementation, all qualified mental health providers contracted with Medicaid Health Plans (MHPs) or Prepaid Inpatient Health Plans (PHPs) must use these standardized assessment tools and follow the new referral protocols beginning in October 2025. Additionally, providers offering services such as inpatient psychiatric care, crisis residentials and partial hospitalization for individuals with lower-level needs will need to contract with MHPs to ensure coverage by 2026.
MHPs will begin covering most mental health services for enrollees with lower levels of mental health need in October 2026, while PIHPs will continue serving those with higher acuity. A state standardized assessment tool, MichCANs for children and LOCUS for adults, will guide this determination. A streamlined referral process and shared platform will also be introduced to help providers and enrollees navigate between systems.
MDHHS is offering free training, eligible for CME/CEU credit, on these tools and processes. Providers are encouraged to complete a form to receive updates and register for training.
Members with questions may contact Lauren LaPine at the MHA.