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MedicaidAdministrativeMedium impact

MMP 22-48

Michigan Medicaid - MDHHS·MI · Geriatrics·Provider Bulletin
Effective date
Jan 1, 2023
We identified it
Jun 20, 2026
Days to comply

Summary

Michigan Medicaid is reinstating policy language allowing Long Term Care Medicaid recipients to offset their Patient-Pay Amount using pre-eligibility medical expenses incurred in the 3 months prior to LTC Medicaid approval. Providers must ensure payments are received directly and requests must be made within one year of eligibility establishment.

Action Required

Action needed
By January 1, 2023: Billing teams serving Long Term Care Medicaid patients must update workflows to identify patients eligible for Pre-Eligibility Medical Expense (PEME) offsets. Train staff to verify that PEME requests are submitted within one year of LTC Medicaid eligibility and that expenses were incurred in the 3 months prior to initial LTC Medicaid approval. Ensure payment tracking shows funds were received directly from patients for medical expenses. Failure to comply will result in termination of offsets.