MedicaidAdministrativeHigh impact
MSA 21-45
Michigan Medicaid - MDHHS·MI·Provider Bulletin
Effective date
Jan 1, 2022
We identified it
Jun 20, 2026
Summary
Michigan Medicaid has updated claim editing requirements effective January 1, 2022, to verify that attending, ordering, and referring provider NPIs match appropriate provider types for the services billed. Claims with inappropriate provider types will be denied. Additionally, the Medical Services Administration has been reorganized under the new Health and Aging Services Administration.
Action Required
Immediately: Billing team must verify all attending, ordering, and referring provider NPIs on claims match appropriate provider types for services being billed according to licensing, scope of practice, and Medicaid policy criteria. Update claim review processes to validate provider type appropriateness before submission. Claims with mismatched provider types will be denied by Michigan Medicaid.