Medicare AdvantageDocumentationMedium impact
MMP 26-26: Revisions to MI Coordinated Health Program Policy
Michigan Medicaid - MDHHS·MI · Geriatrics, Palliative Care, Occupational Therapy +2 more·Medical Policy
Effective date
Aug 1, 2026
We identified it
Jul 2, 2026
Summary
MMP 26-26 revises Michigan's MI Coordinated Health (MICH) program policy effective August 1, 2026, clarifying requirements for HIDE SNPs operating in four defined regions. Key changes include updated Individualized Care Plan (ICP) requirements for HCBS waiver enrollees, removal of the Personal Care Services Reasonable Time Schedule (RTS), clarification on concurrent enrollment with behavioral health programs, new rules for Adaptive Medical Equipment coverage, out-of-state disenrollment procedures, and mandatory provider enrollment in CHAMPS with criminal history reviews.
Action Required
By August 1, 2026: Billing and care coordination teams must implement the following changes: (1) Update ICP documentation templates to include all mandatory elements for residential settings (setting options, enrollee resources, roommate preferences, community engagement plans, safety risks, and policy modifications with justification for provider-owned settings). (2) Remove all references to the Personal Care Services (PCS) Reasonable Time Schedule (RTS) from billing guidance and staff training materials. (3) Update service authorization logic to allow concurrent ECLS and State Plan PCS billing for the same ADL/IADL on the same day at different times, with distinct minute allocations per the policy examples. (4) Verify all MICH providers are enrolled in CHAMPS (Community Health Automated Medicaid Processing System), including Adaptive Medical Equipment/Assistive Technology providers, Fiscal Intermediaries, EVV-required agencies, and NEMT providers; reject claims from non-enrolled providers. (5) Implement criminal history review and reference check verification before authorizing any provider who will enter enrollee residences. (6) Update disenrollment procedures to discontinue HCBS waiver services immediately (not through month-end) when an enrollee moves out of state permanently, while maintaining non-waiver services through the disenrollment date. (7) Ensure care coordination with PIHPs per SMAC requirements. Compliance is required for all MICH claims submitted on or after the effective date; non-compliant claims will be denied.