Michigan Medicaid UpdateMay, 2017

Approved Medicaid Policy 2016Changes in Benefit Administration of MIHP Services for Individuals

Enrolled in Medicaid Health Plans (MSA 16-33)

Chapter updates for 16-33 have been incorporated into the MPM as of April 1. www.Michigan.gov/mdhhs : Doing Business with MDHHS>Health Care Providers>Providers> Medicaid>Policy and Forms>Medicaid Provider Manual

Approved Medicaid Policy 2016Changes in Benefit Administration of MIHP Services for Individuals

Enrolled in Medicaid Health Plans (MSA 16-33)

A few points of clarification:• Provision of out-of-network services • Care Coordination Agreement • MIHP/MHP communication and referral form• Lactation Services • MHP Contact List • FFS take back after infant MHP enrollment

Lead Abatement Services (MSA 17-05)• Coordinated and targeted lead abatement services are being

provided to eligible properties in Flint, Michigan and other areas within the State of Michigan to ameliorate all lead risks impacting eligible individuals.

• Eligible properties include owner-occupied, rental, and those residential structures that an eligible individual, under the age of 19, or pregnant woman is currently residing, or visited regularly.

Approved Medicaid Policy 2017

Lead Abatement Services (MSA 17-05)• Abatement services are defined as the removal of lead hazards, including:

• Permanent removal, or enclosure, or encapsulation of lead based paint and lead dust hazards.

• Removal and replacement of surfaces or fixtures.• Removal or covering of soil lead hazards up to the property line.• All preparation, lab sampling analysis, clean up, disposal, and pre-and post-abatement

paint, dust, soil and clearance testing activities associated with such measures including pre- and post-abatement water sampling.

Approved Medicaid Policy 2017

Approved Medicaid Policy 2017Family Planning Services for Maternity Outpatient Medical Services

(MOMS) Program Enrollees (MSA 16-47) • Effective for dates of service on or after February 3, 2017,

beneficiaries of the MOMS benefit plan will be eligible for family planning services during their 60-day post partum period of eligibility.

Fee-For-Service Medicaid Provider Enrollment and Transportation Rate Changes and Clarification (1704-NEMT)

• In compliance with the Affordable Care Act (ACA), all Non-Emergency Medical Transportation (NEMT) providers must consent to necessary background screenings. Demand-responsive public transit services and commercially hailed or street taxicabs are exempt at this time.

Beginning November 1, 2017, all MIHP transportation providers must be enrolled in CHAMPS and screened prior to being authorized, approved, or reimbursed for transportation services for FFS beneficiaries. Transportation providers may begin enrolling in CHAMPS July 1, 2017.

Proposed Medicaid Policy 2017

Fee-For-Service Medicaid Provider Enrollment and Transportation Rate Changes and Clarification (1704-NEMT)

• NEMT “providers” include:1. Beneficiaries who utilize a personal vehicle to transport themselves to services

Medicaid covers2. Individuals with or without a vested interest in the livelihood of the Medicaid

beneficiary who transport the beneficiary to services Medicaid covers3. Non-profit and commercial transportation agencies and their employees4. Medicaid’s transportation contract or and their transportation subcontractors

• Demand-responsive public transit services and commercially hailed or street taxicabs are exempt from CHAMPS enrollment requirements at this time.

Proposed Medicaid Policy 2017

Fee-For-Service Medicaid Provider Enrollment and Transportation Rate Changes and Clarification (1704-NEMT)

• MIHP agency providers must verify transportation provider enrollment prior to authorizing transportation services. MIHP providers will have increased access to CHAMPS to verify provider enrollment compliance.

• No changes to the claims submission process or mechanism of payment will be made as a result of this policy.

Proposed Medicaid Policy 2017

Fee-For-Service Medicaid Provider Enrollment and Transportation Rate Changes and Clarification (1704-NEMT)

• Rate update: Beginning July 1, 2017, FFS NEMT mileage reimbursement will align with the standard mileage rates maintained by the Internal Revenue Service (IRS). Individuals with a vested interest or Medicaid beneficiaries providing their own NEMT will be reimbursed at 17 cents per mile.

Public Comment period ends May 3, 2017

Proposed Medicaid Policy 2017

Proposed Medicaid Policy 2017

Intensive Crisis Stabilization Services for Children (1705-CMH)• Structured treatment and support activities designed to quickly address a crisis

situation in order to avert a psychiatric admission or other out of home placement or to maintain a child or youth in their home or present living arrangement who has recently returned from a psychiatric hospitalization or other out of home placement.

• These services must be available to children or youth with serious emotional disturbance (SED) and/or intellectual/developmental disabilities (I/DD) including autism, or co-occurring SED and substance use disorder (SUD).

Public comment period ends May 1, 2017

• Pregnant women and children up to age 21 with household income up to and including 400% of the Federal Poverty Level who were serviced by the Flint water system on or between April 1, 2014, and the date the water is deemed safe by the appropriate authorities are eligible to receive full Medicaid coverage, as well as targeted case management (TCM) services.

• TCM services assist individuals in gaining access to appropriate medical, educational, social, and/or other services. TCM services include assessments, planning, linkage, advocacy, care coordination, referral, monitoring, and follow-up activities.

Other Policy Clarification and Follow Up: Flint Water Group

• An individual was served by the Flint water system if he or she consumed water drawn from the Flint water system during the specified time period and:

1. Currently resides or resided in a dwelling connected to the Flint water system, 2. Is employed or had employment at a location served by the Flint water system, or 3. Is receiving or received child care or education at a location served by the Flint

water system.

• Those who were impacted and exposed to Flint water during the outlined time period are eligible for these services even if they have since moved out of the affected areas.

Other Policy Clarification and Follow Up: Flint Water Group

• Medicaid Provider Manual; Maternal Infant Health Chapter• www.Michigan.gov/mdhhs : Doing Business with MDHHS>Health Care Providers>Providers>

Medicaid>Policy and Forms>Medicaid Provider Manual

• Medicaid Provider Bulletins• www.Michigan.gov/mdhhs : Doing Business with MDHHS>Health Care Providers>Providers>

Medicaid>Policy and Forms• Finalized Policy Bulletins are categorized by year of issue for ease of access.

• Notice of Proposed Policy• If you would like to receive a copy of Notices of Proposed policy, complete MSA-0209

(Request to Participate in Proposal Review).• Fax completed form to (517)335-5136 or email to MSADraftPolicy@Michigan.gov.

Resources

Thank you!Elizabeth Campbell

CampbellE5@Michigan.gov