Tag: MHPs

MDHHS to Discuss 2026 Draft Rates for MichiCANS and LOCUS Assessments

Member News

The Michigan Department of Health and Human Services (MDHHS) invites qualified mental health providers to attend a MichiCANS Screener and Level of Care Utilization System (LOCUS) All Provider Draft Rate meeting scheduled from 1 – 2 p.m. ET Aug. 6. The meeting will provide important context for upcoming Medicaid policy changes and explain how draft comparison payment rates were developed for the 2026 fiscal year MichiCANS and LOCUS assessments. Providers will also have the opportunity to share feedback on the proposed rate methodology. Members are encouraged to register and attend the meeting.

Beginning in October 2025, all qualified Medicaid mental health providers contracted with Medicaid health plans (MHPs) and/or prepaid inpatient health plans (PIHPs) must begin using the MichiCANS screener for individuals under 21, or the LOCUS for those 21 and older. Providers must also follow a standardized referral process for mental health services.

Starting in October 2026, MHPs will expand coverage to include additional services for individuals with lower levels of mental health need. These services include inpatient psychiatric care, crisis residential services, partial hospitalization and targeted case management. Providers of these services should prepare to contract with both MHPs and PIHPs.

Members with questions may contact MHA Policy department at the MHA.

MDHHS Medicaid Provider Manual Available April 1

Member News

The Michigan Department of Health and Human Services (MDHHS) recently completed the April 2025 update to the MDHHS Medicaid Provider Manual, which will be available online April 1, 2025. This update aims to clarify coverage responsibilities among Medicaid Health Plans (MHPs), Prepaid Inpatient Health Plans (PIHPs) and Medicaid Fee-for-Service (FFS) to improve service delivery and reduce confusion among providers and beneficiaries.

The update specifically addresses coverage responsibilities for psychological and neuropsychological evaluations, including:

  • MHPs will remain responsible for evaluations related to mild to moderate conditions, particularly when driven by medical necessity.
  • PIHPs will handle evaluations and treatment if a severe condition is suspected.
  • Medicaid FFS will cover behavioral health screenings, including psychological and neuropsychological evaluations, when performed by primary care providers or other qualified professionals for FFS beneficiaries. If a service is not included under the PIHP benefit or is provided by a non-PIHP enrolled provider, Medicaid FFS will assume coverage. However, if the beneficiary qualifies for PIHP services, the PIHP will take over coverage.

These clarifications will also be incorporated into the Beneficiary Eligibility subsection within the Behavioral Health and Intellectual and Developmental Disability Supports and Services section of the Medicaid Provider Manual. This update ensures that providers better understand their roles in delivering psychological and neuropsychological evaluations and that beneficiaries receive appropriate services based on their needs.

Members with questions may contact Lauren LaPine at the MHA.