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MedicaidAdministrativeHigh impact

MSA 17-40

Michigan Medicaid - MDHHS·MI·Provider Bulletin
Effective date
Jan 1, 2018
We identified it
Jun 20, 2026
Days to comply

Summary

Michigan Medicaid is implementing major system changes effective January 1, 2018, replacing Level of Care (LOC) codes with new Program Enrollment Type (PET) codes and moving Patient Pay Amount information to a separate section in eligibility responses. Managed care entities will consolidate to single provider IDs per contract.

Action Required

Action needed
Before January 1, 2018: Billing team must update eligibility verification procedures to look for new PET codes in Benefit Plans section instead of LOC codes. Update systems to check Patient Pay Amount information in the new separate 'Patient Pay' section at bottom of eligibility responses rather than LOC segment. Ensure provider enrollment is associated with correct single CHAMPS provider ID for each managed care contract. Update HIPAA 270/271 companion guides from MDHHS website when available.