MedicaidCoverageLow impact
MSA 16-12
Michigan Medicaid - MDHHS·MI · Pediatrics, Pharmacy·Provider Bulletin
Effective date
Jul 1, 2016
We identified it
Jun 20, 2026
Summary
Michigan's Children's Special Health Care Services (CSHCS) will now cover out-of-pocket pharmacy costs (copays, co-insurance, and deductibles) for Medicare Part D enrollees when medications are related to their CSHCS-covered diagnoses. Providers should contact the CSHCS reimbursement specialist for information about billing these pharmacy costs.
Action Required
For Michigan providers treating CSHCS beneficiaries with Medicare Part D: Contact CSHCS reimbursement specialist at (517) 241-7186 to understand billing procedures for Medicare Part D out-of-pocket pharmacy costs related to CSHCS-covered diagnoses. Update billing workflows to identify these patients and coordinate reimbursement for applicable pharmacy costs.