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MedicaidCoverageMedium impact

MMP 23-68: Updates to the Medicaid Provider Manual; Rapid Whole Genome Sequencing Coverage Clarification

Michigan Medicaid - MDHHS·MI · Genetics, Critical Care, Pediatrics·Medical Policy
Effective date
Jan 1, 2024
We identified it
Jun 20, 2026
Days to comply

Summary

Michigan Medicaid updated their Provider Manual with quarterly changes and clarified that rapid whole genome sequencing (rWGS) testing is only covered for critically ill inpatients when results will directly impact hospital management decisions. The policy also includes various technical updates throughout the manual including terminology changes and authorization process updates.

Action Required

Action needed
By January 1, 2024: Providers should review the updated Michigan Medicaid Provider Manual online at www.michigan.gov/medicaidproviders. For practices ordering rapid whole genome sequencing, ensure rWGS is only ordered for critically ill inpatients when results will directly impact hospital management. Update any internal protocols to reflect the clarified coverage criteria for rWGS testing.