Tag: MDHHS

Medicaid Eligibility Redetermination Webinar Recording Available

Member News

The Michigan Medicaid program has grown to nearly 3.2 million Michiganders, an increase of more than 700,000 when compared to pre-pandemic levels, due to federal statutory limitations on states’ abilities to remove people from the program during the public health emergency. The Michigan Department of Health and Human Services (MDHHS) recently released a final policy bulletin informing providers that Medicaid eligibility redeterminations will resume in June 2023 for the first time since early 2020, with some enrollees who no longer meet program eligibility criteria losing coverage as early as July.

The MHA, in partnership with the Michigan Primary Care Association, Michigan Association of Health Plans, Michigan State Medical Society and Michigan Osteopathic Association, hosted a member webinar March 20 to cover the Medicaid eligibility redetermination process, timelines and provider roles. A recording of this webinar is available.

Hospitals are encouraged to discuss the importance of updating Medicaid patient contact information in the state’s MI Bridges system and how to maintain Medicaid coverage or find new coverage on the federal marketplace.

Members with questions are encouraged to contact Jason Jorkasky at the MHA.

March 30 Webinar Outlines Considerations for the End of the Public Health Emergency

Member News

The Department of Health and Human Services (DHHS) COVID-19 public health emergency expires May 11, 2023, which may significantly decrease the flexibility providers have become accustomed to.

The MHA will host The End of the COVID-19 Public Health Emergency (PHE) and Preparing for the New Regulatory Environment webinar from 4 to 5 p.m. March 30, 2023, providing practical guidance on unwinding reliance on the COVID-19 public health emergency flexibilities. The webinar will identify the steps hospitals should take to prepare for the end of the federal and state public health emergency, review the status of waivers and extensions of PHE-oriented flexibilities and outline how the Michigan Department of Health & Human Services will work with providers in determining which COVID-19 response policies will end, be modified or remain permanently. Experts from Jones Day and the MHA staff will present and answer questions.

Chief executives, financial, medical and nursing executives, legal counsel, patient account and revenue cycle directors, government relations officers, public relations directors and human resources directors are encouraged to register. The webinar is free of charge and open to MHA member organizations only.

Members with questions should contact Brenda Carr at the MHA.

Changes to Telemedicine Policy Post-COVID-19 Public Health Emergency

Member News

The Michigan Department of Health and Human Services (MDHHS) will rescind certain COVID-19 telemedicine flexibilities beginning May 12, 2023, with the conclusion of the federal health public health emergency. Policy MMP 23-10 outlines flexibilities that will remain permanent and which flexibilities will be rescinded. Notable permanent flexibilities include:

  • Reimbursement: The telemedicine reimbursement rate for allowable services will be the same as the in-person reimbursement rate. Providers must report the place of service as they would if they were providing the service in-person.
  • Audio-Only: Audio-only services will be allowed for the procedure codes CPT/HCPCS 99441-99443 and 98955-98968. The MDHHS will create an audio-only database for providers to reference.
  • Prior Authorizations: There are no prior authorization (PA) requirements when providing telemedicine services for fee-for-service beneficiaries or those accessing behavioral health services through prepaid inpatient health plans/community mental health services programs unless the equivalent in-person service requires a PA. The PA requirements for Medicaid health plans (MHP) may vary and providers should refer to individual MHPs for any PA requirements.
  • MSA 20-09 General Telemedicine Policy Changes will be permanent and remain effective with the Facility Rate subsection redacted.
  • MSA 21-24 Asynchronous Telemedicine Services will be permanent and remain effect.

Rescinded telemedicine policies include:

  • MSA 20-13 COVID-19 Response: Telemedicine Policy Expansion.
  • MSA 20-15 COVID-19 Response: Behavioral Health Telepractice; Telephone (Audio Only) Services.
  • MSA 20-34 COVID-19 Response: Telemedicine Reimbursement for Federally Qualified Health Centers.
  • MSA 20-21 COVID-19 Response: Limited Oral Evaluation via Telemedicine.

Members with questions may contact Renée Smiddy at the MHA.

Changes to Medicaid Dental Coverage Effective April 1

Member News

The Michigan Department of Health and Human Services will implement a new service delivery model for adult dental benefits effective April 1, 2023. The following groups will be eligible:

  • Medicaid beneficiaries ages 21 years and older (including Healthy Michigan Plan).
  • Pregnant women enrolled in Medicaid Health Plans (MHP).
  • Integrated Care Organizations (ICO).
  • Program of All-Inclusive Care for the Elderly (PACE).

Health plans will be responsible for the beneficiary’s dental services, which must be obtained through the health plan’s dental provider network. The new model replaces Healthy Michigan Plan and pregnant women dental benefits. Therefore, questions regarding prior authorizations should be directed to the beneficiary’s health plan.

Dental benefits for Healthy Michigan Plan beneficiaries ages 19-20 will be provided by the Medicaid health plan. Beneficiaries not enrolled in an MHP, ICO or PACE will receive dental services through the Medicaid fee-for-service program. Beneficiaries enrolled in Healthy Kids Dental and under the age of 21 will receive dental coverage through Healthy Kids Dental.

Members with questions may contact Renée Smiddy at the MHA.

 

MDHHS Candida auris Patient Transfer Recommendations

Member News

Candida auris (C. auris) cases have been reported in multiple healthcare facilities in Michigan, including acute care hospitals, long-term acute care hospitals and skilled nursing facilities. Auris is a yeast pathogen that can cause serious illness or invasive infections, including bloodstream infections. C. auris can spread from colonized or infected patients to the hands and clothes of healthcare personnel or to medical equipment and environmental surfaces, which may contribute to the spread of C. auris among patients in healthcare facilities.

With a continued increase in C. auris cases across Southeast Michigan, receiving healthcare facilities should take steps to learn a patient’s C. auris status and be prepared to implement setting-appropriate precautions when needed for C. auris, as they would for other multidrug-resistant organisms (MDRO).

The Michigan Department of Health and Human Services (MDHHS) recommends that Michigan healthcare facilities across the continuum implement the following infection prevention and control measures to prevent the spread of C. auris:

MDHHS also recommends the following measures for interfacility patient transfers:

  • Review both internal and external protocols to ensure the appropriate persons (including case managers, admissions coordinators, front-line clinical HCP, and transporters) are made aware of a patients’ C. auris and other MDRO status upon transfer.
  • Use an interfacility transfer form to communicate infection prevention information for all discharges to other settings. For Facility Transfer Resources and more information on HAIs, please go to Michigan.gov/HAI.

To learn more about C. auris contact the MDHHS Surveillance for Healthcare-Associated and Resistance Pathogens (SHARP) Unit. Members are encouraged to register for future SHARP webinars about C. auris.

Members with questions may contact Kelsey Ostergren at the MHA.

Resources, Webinars Available for Navigating Medicaid Eligibility Changes

Member News

The Michigan Department of Health and Human Services (MDHHS) recently released a final policy bulletin informing providers that Medicaid eligibility redeterminations will resume in June 2023 for the first time since early 2020, with some enrollees who no longer meet program eligibility criteria losing coverage as early as July.

The Medicaid program has grown to nearly 3.2 million Michiganders, an increase of more than 700,000 when compared to pre-pandemic levels. The MDHHS will complete eligibility redeterminations for all Medicaid enrollees over a 12-month period. Hospitals are encouraged to discuss the importance of updating Medicaid patient contact information in the state’s MI Bridges system and how to maintain Medicaid coverage or find new coverage on the federal marketplace. Hospitals are invited to join the MHA, the Michigan Primary Care Association, the Michigan Association of Health Plans and other stakeholders for a members-only webinar March 20. This will cover the redetermination processes, timelines and provider roles.

The MDHHS also announced that it has started unwinding many of the changes that were made to the Michigan Medicaid program in order to ease rules and provide flexibilities to providers as a result of the COVID-19 public health emergency (PHE). Michigan will continue to unwind the pandemic-related program changes before the authority for these policies expires on May 11, 2023. The MHA will host an additional webinar on March 30 to cover details of the PHE ending and what hospitals need to know.

The MDHHS developed a website with information important to providers that will be updated as new information becomes available. The Centers for Medicare & Medicaid Services also recently released a fact sheet related to the PHE expiration’s impact on:

  • COVID-19 vaccines, testing, and treatments.
  • Telehealth services.
  • Healthcare access and continuing flexibilities for healthcare professionals.
  • Inpatient hospital care at home.

Members with questions are encouraged to contact Jason Jorkasky at the MHA.

Webinar Outlines Considerations for the End of the Public Health Emergency

Member News

The Department of Health and Human Services (DHHS) COVID-19 public health emergency expires May 11, 2023, which may significantly decrease the flexibility providers have become accustomed to.

The MHA will host The End of the COVID-19 Public Health Emergency (PHE) and Preparing for the New Regulatory Environment webinar from 4 to 5 p.m. March 30, 2023, providing practical guidance on unwinding reliance on the COVID-19 public health emergency flexibilities. The webinar will identify the steps hospitals should take to prepare for the end of the federal and state public health emergency, review the status of waivers and extensions of PHE-oriented flexibilities and outline how the Michigan Department of Health & Human Services will work with providers in determining which COVID-19 response policies will end, be modified or remain permanently. Experts from Jones Day and the MHA staff will present and answer questions.

Chief executives, financial, medical and nursing executives, legal counsel, patient account and revenue cycle directors, government relations officers, public relations directors and human resources directors are encouraged to register. The webinar is free of charge and open to MHA member organizations only.

Members with questions should contact Brenda Carr at the MHA.

Application Period Begins for Michigan Opioid Treatment Access Loan Repayment Program

Member News

Applications for the Michigan Opioid Treatment Access Loan Repayment Program (MIOTA) will be accepted from Feb. 27 through March 13.

MIOTA is a medical education debt repayment program focused on incentivizing healthcare providers to begin and expand opioid treatment in Michigan. Funded through the Michigan Opioid Healing and Recovery Fund, the goal of MIOTA is to increase availability of opioid use disorder treatment across the state, especially in areas where treatment is difficult to access.

This program is available to medical providers (MD, DO, NP, PA) and Substance Use Disorder (SUD) counselors. Medical providers must either:

  • Begin providing medication opioid used disorder treatment in Michigan by having obtained a standard Drug Enforcement Agency (DEA) registration certificate.
  • Already be providing treatment using a standard DEA registration certificate.
  • Provide services as a SUD counselor within an opioid treatment program or serving individuals with an Opioid Use Disorder, Stimulant Use Disorder or SUD program.

Applicants are strongly encouraged to review the program guidance to learn more about MIOTA eligibility requirements. For additional information, contact Megan Linton at the Michigan Department of Health and Human Services.

Members with questions may contact Lauren LaPine at the MHA.

CHAMPS Registration Required for Medicaid Doula Services

Member News

The Michigan Department of Health and Human Services (MDHHS) will reimburse for doula services provided to individuals covered by Medicaid beginning Jan. 1, 2023. Doula providers are required to be registered and approved on the MDHHS Doula Registry and enrolled in the Community Health Automated Medicaid Processing System (CHAMPS) as a Medicaid provider. Doulas should contact the Medicaid health plan (MHP) prior to providing services to MHP enrollees, as doulas must be contracted with the MHP or receive approval to provide out-of-network services.

Doulas must be at least 18 years old and possess a high school diploma or equivalent credentials. The MDHHS will certify doulas who have completed training provided by an MDHHS-approved training program or organization.

Additional resources include:

Additional information and resources can be found on the MDHHS Doula Initiative website. The CHAMPS provider enrollment process and resources can be found on the Provider Enrollment website.

Members with questions should contact Vickie Kunz at the MHA.

State Loan Repayment Program Application Period Begins

Member News

Applications for the 2023 Michigan State Loan Repayment Program (MSLRP) will be accepted from March 6-31 through the File Transfer Application System. Providers are strongly encouraged to create an account in the system before starting the application period.

The MSLRP assists employers in the recruitment and retention of medical, dental and mental health primary care providers who continue to demonstrate their commitment to building long-term primary care practices in underserved communities designated as Health Professional Shortage Areas. Those selected will receive up to $300,000 in tax-free funds to repay their educational debt over a period of up to ten years of participation. Priority will be given to applications from:

  • Inpatient pediatric psychiatrists, physician assistants and nurse practitioners.
  • Genesee County applicants.
  • Obstetric service providers working in northern Michigan.

The review process has been updated for this application period. Providers and employers are strongly encouraged to read more about the review process in the Selection Criteria, Application Review and Final Phase Process section of the MSLRP website. For more information, contact Brittany Brookshire at the Michigan Department of Health and Human Services.

Members with questions may contact Lauren LaPine at the MHA.