MedicaidAdministrativeHigh impact
MSA 16-40
Michigan Medicaid - MDHHS·MI·Provider Bulletin
Effective date
Jan 1, 2017
We identified it
Jun 20, 2026
Summary
Michigan Medicaid is implementing a Benefits Monitoring Program (BMP) that requires all ambulatory services to be provided, referred, prescribed, or ordered by an assigned Authorized Provider for high-utilization beneficiaries. Claims will be denied if they don't include appropriate authorization information from the assigned BMP provider.
Action Required
Before January 1, 2017: Billing team must verify all Michigan Medicaid and Healthy Michigan Plan claims include appropriate BMP Authorized Provider information before submission. Update claim review process to check if patient is enrolled in BMP and ensure services were provided/ordered by assigned provider. Claims without proper BMP authorization will be denied.