MedicaidAdministrativeHigh impact
MSA 18-48
Michigan Medicaid - MDHHS·MI · Geriatrics, Internal Medicine, Family Medicine·Provider Bulletin
Effective date
Jan 1, 2019
We identified it
Jun 20, 2026
Summary
Michigan Medicaid has consolidated and updated the Nursing Facility Level of Care Determination (LOCD) process, requiring face-to-face assessments before Medicaid reimbursement can begin and eliminating the previous 14-day retroactive payment window. The policy introduces passive redetermination using automated algorithms and requires all LOCD assessments to be entered in the CHAMPS system.
Action Required
By January 1, 2019: Nursing facilities and long-term care providers in Michigan must conduct initial face-to-face LOCD assessments on or before the first day of services to receive Medicaid reimbursement. Update billing workflows to eliminate reliance on the previous 14-day retroactive billing window. Ensure all LOCD determinations (including negative determinations) are entered into the CHAMPS system within 14 days of assessment. Train staff on new passive redetermination notifications and 45-day response requirements for follow-up assessments.