MedicaidAdministrativeMedium impact
MMP 22-36
Michigan Medicaid - MDHHS·MI · Psychiatry, General Practice, Family Medicine +1 more·Provider Bulletin
Effective date
Oct 1, 2023
We identified it
Jun 20, 2026
Summary
Michigan's behavioral health community-based services are transitioning from waiver programs to §1915(i) State Plan Home and Community-Based Services (HCBS) effective October 1, 2023. This affects Medicaid, Healthy Michigan Plan, and MIChild beneficiaries with serious emotional disturbance, mental illness, or intellectual/developmental disabilities who need community-based behavioral health services.
Action Required
By October 1, 2023: Billing teams serving Michigan Medicaid patients must understand that behavioral health community-based services now operate under §1915(i) State Plan authority concurrently with §1115 Behavioral Health Demonstration Waiver. Verify that patients meet new needs-based criteria including substantial functional limitations in areas like self-care, communication, learning, or mobility. Ensure proper coordination with Prepaid Inpatient Health Plans (PIHPs) for assessments and Individual Plan of Service (IPOS) development, as eligibility determinations are now made by BPHASA through independent evaluations.