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MedicaidCoverageMedium impact

MSA 18-50

Michigan Medicaid - MDHHS·MI·Provider Bulletin
Effective date
Jan 1, 2019
We identified it
Jun 20, 2026
Days to comply

Summary

Effective January 1, 2019, Medicaid will pay claims for Medicare-eligible beneficiaries who are not enrolled in Medicare Part A or Part B for Medicaid-covered services. Providers must bill Medicare once beneficiaries obtain Medicare coverage, and claims will be voided if Medicare coverage is later obtained.

Action Required

Action needed
Billing team must identify Medicare-eligible Medicaid beneficiaries not enrolled in Medicare and bill Medicaid for covered services. Establish workflow to monitor when these beneficiaries obtain Medicare coverage and switch billing to Medicare. Update patient eligibility verification process to check both Medicaid and Medicare enrollment status. Train staff to refer unenrolled Medicare-eligible patients to Social Security offices or MMAP at 1-800-803-7174.