MedicaidAdministrativeMedium impact
MMP 25-28: Children’s Waiver Program
Michigan Medicaid - MDHHS·MI · Pediatrics, Psychiatry, Physical Therapy +1 more·Provider Bulletin
Effective date
Sep 1, 2024
We identified it
Jun 20, 2026
Summary
Michigan Medicaid's Children's Waiver Program removes the GAF score eligibility requirement and streamlines prior authorization processes by transferring review responsibilities from MDHHS to PIHPs. Enhanced Transportation is eliminated as a benefit, with patients directed to use standard Non-Emergency Medical Transportation.
Action Required
Immediately: Update billing workflows for Michigan Medicaid Children's Waiver Program patients. Stop billing for Enhanced Transportation services - redirect patients to Non-Emergency Medical Transportation (NEMT). Submit all Prior Review and Approval Requests (PRARs) for Community Living Supports, Environmental Accessibility Adaptations, and Specialized Medical Equipment to the overseeing PIHP instead of MDHHS. Update eligibility screening to remove GAF score requirement.