MedicaidCoverageHigh impact
MSA 18-05
Michigan Medicaid - MDHHS·MI·Provider Bulletin
Effective date
Apr 1, 2018
We identified it
Jun 20, 2026
Summary
Michigan is creating a new MI Marketplace Option that will transition certain Healthy Michigan Plan beneficiaries to marketplace-style health plans with more limited benefits. This affects eligibility verification, prior authorization processes, and billing workflows for Michigan providers serving Medicaid patients.
Action Required
By April 1, 2018: Billing team must update eligibility verification systems to recognize new benefit plan codes MKPL-MC and MA-MKPL. Train staff to verify coverage through CHAMPS portal for each service date. Providers must obtain new prior authorizations from MI Marketplace Option health plans as previous Healthy Michigan Plan authorizations will not be honored. Update patient registration to identify beneficiaries transitioning between plans and verify current coverage before each appointment.