final policy - MHA | Michigan Health & Hospital Association

The Michigan Department of Health and Human Services (MDHHS) recently released a final policy to establish Medicaid reimbursement for rural emergency hospitals (REHs) effective Jan. 1, 2023. The MDHHS reimburses REHs based on the existing outpatient prospective payment system (OPPS) methodology. Critical access hospitals (CAHs) that convert will continue to be paid using the enhanced OPPS reduction factor, while non-CAHs will continue to be paid using their existing OPPS reduction factor. REHs must update their enrollment and subspecialty with the MDHHS through the Community Health Automated Medicaid Processing System (CHAMPS) provider enrollment system within 35 days of any change. Hospitals that convert to REHs must end date their inpatient specialty.

Members with questions regarding the policy should contact Vickie Kunz while members that need assistance evaluating potential conversion should contact Lauren LaPine at the MHA.

The Michigan Department of Health and Human Services (MDHHS) recently released a final policy to increase the minimum Medicaid payment rates to $2,300 for covered dental services provided under general anesthesia at outpatient hospitals and $1,495 for services provided in an ambulatory surgical center (ASC).

The policy took effect Oct. 1, 2022 and was approved by the Centers for Medicare and Medicaid Services in early November. The policy modified the reimbursement methodology for dental services provided in these settings from the outpatient prospective payment system to a Medicaid fee schedule. Outpatient hospital and ASC fee schedules are available on the MDHHS website under the Billing and Reimbursement and Provider Specific Information tabs.

Members with questions should contact Vickie Kunz at the MHA.

Tag: final policy

MDHHS Releases REHs Medicaid Reimbursement Final Policy

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Michigan Health & Hospital Association