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MedicaidAdministrativeMedium impact

MSA 17-02

Michigan Medicaid - MDHHS·MI·Provider Bulletin
Effective date
Apr 1, 2017
We identified it
Jun 20, 2026
Days to comply

Summary

Healthy Michigan Plan copay amounts are increasing effective April 1, 2017, with two-tiered rates based on beneficiary income (above/below 100% Federal Poverty Level). The billing team must verify copay amounts through CHAMPS eligibility system for each service and collect appropriate copays at point of service for non-managed care enrollees.

Action Required

Action needed
By April 1, 2017: Front desk staff must check CHAMPS eligibility system for every Healthy Michigan Plan patient to determine correct copay tier (income above/below 100% FPL). Update fee collection procedures to reflect new copay amounts: physician visits ($2/$4), outpatient clinic visits ($1/$4), ER non-emergency ($3/$8), inpatient stays ($50/$100), and pharmacy ($1-3/$4-8). Train staff that managed care enrollees pay copays through MI Health Account, not at point of service.