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    State Plan Amendments


    Update of the Ambulatory Surgical Center (ASC) budget neutrality factor.(13-03)Submitted 

    Citizenship and Non-Citizenship Eligibility.(MI 13-0150) Approved 

    Eligibility Process.(MI 13-0140) Approved 

    Presumptive Eligibility by Hospitals.(MI 13-0120) Submitted 

    Federal Medical Assistance Percentage (FMAP) Claiming State Plans.(SPA 14-03) Submitted 

    Graduate Medical Education (GME) Innvoations Grant.(SPA 14-02) Submitted 

    Inpatient Hospital Care Rate Update.(SPA 14-05) Submitted 

    Public Entity Adjustment Program.(SPA 13-10) Approved 

    Medicaid Alternative Benefit Plan.(SPA MI-14-0001) Submitted 

    Medicaid Co-Payment Exemptions.(13-16) Submitted 

    MI Single State Agency.(MI 13-0130) Submitted 

    Modify the National Medicaid Pooling Initiative (NMPI) Supplemental Rebate Agreement.(13-12) Submitted 

    Modified Adjusted Gross Income (MAGI)- Groups.(13-0100) Approved 

    Modified Adjusted Gross Income (MAGI)- Based Income Methodologies.(13-0110-MM3) Approved 

    Pathologist - Licensing Requirement.(13-11) Submitted 

    School Based Services Transportation.(SPA 13-17)Submitted 

    State Residency.(MI 13-0160) 

    State Long-Term Care Insurance Partnership.(SPA 13-15)Submitted 


    Applied Behavioral Analysis (ABA) for eligible beneficiaries age 18 months through five years of age with a clinical diagnosis of Autism Spectrum disorder (ASD).(12-15) Approved 

    Ambulatory Surgical Center (ASC) Reduction Factor.(13-03) Approved 

    Capital Interim Payment.(13-07) Approved 

    Add Centeral Michigan University to the Physician Adjuster Program. (12-14) Approved 

    Disproportionate Share Hospital (DSH)Pool Dollar Amount. (13-04) submitted 

    DSH Pool - Modify Indigent Care Agreement(ICA).(13-13) submitted 

    DSH Pool - Modify Fiscal Year 2013 Outpatient Uncompensated Care.(13-14) submitted 

    DRG Update and Per Diem Rebase.(13-08) Approved 

    Family Planning. (12-04) submitted 

    Home Maintenance.(13-05) Approved 

    Elimination of Maximum Daily Dollar Limits for Laboratory Services.(12-21) approved 

    Medicare Part D.(13-09) Approved 

    Public Assistance Reporting Information System.(13-02) approved 

    Public Entity Adjustment Program (PEA).(13-10) Submitted 

    Recovery Auditor Contractor (RAC) Program Exception.(13-06) Approved 

    Primary Care Physician Rate Increase. (13-01) Approved 

    Reinstate Vision Services for Medicaid Beneficiaries Age 21 and Older. (12-13) approved 

    Removes inconsistent State Plan language regarding optional coverage of respiratory care services in accordance with 1902(e)(9)(A)through (C). (12-18) approved 

    Establishment of a Rural Access Pool.(12-20) Approved 


    Affordable Care Act for provider screening, enrollment of referring/ordering providers, and provider termination requirements to comply with Sections 6401 and 6501. (12-03) approved 

    Ambulatory Surgical Centers (ASC) Reimbursement. (12-02) approved 

    Reinstatement of chiropractic services for beneficiaries age 21 and older. (12-11) approved 

    Corporate Income Tax. (11-12) approved 

    Disproportionate Share Hospital (DSH) Process Reform. (12-16) Withdraw 

    Disproportionate Share Hospital (DSH) Pool Modification. (12-17) Approved 

    DRG Update and Per Diem Rebase. (12-05) approved 

    Estate Recovery. (12-10) approved 

    GME Funds Pool. (11-16)approved 

    GME Funds Pool for FY2012 and FY2013. (12-12)approved 

    Home Maintenance. (12-07) approved 

    Long term care provider appeals process - Revises. (12-09) approved 

    Medicaid RAC-Exception to the Implementation Date March 31, 2012. (11-13) approved 

    Multi-payer demonstration project to reform primary care payment models and expand the capabilities of patient-centered medical homes (PCMH) throughout Michigan - Implementation. (12-06) Approved 

    Non-compliant State Plan language removal for covered excluded drugs. (12-01) approved 

    Nursing Facility Rate Relief. (11-15) approved 

    Optometry Services (12-08) approved 

    PACE Rates Revised. (11-02) approved 

    Physician Adjustor Program. (11-14) approved 

    Public Clinic Services. (11-04) approved 


    Addition of Public Entity (Oakland University) to Physician Adjustor Program. (10-21) approved 

    Addition of Registered/Licensed Dental Hygienists as Enrolled Providers in the Michigan Medicaid Program. (10-05) approved 

    Ambulatory Surgical Centers - Reimbursement. (10-12)approved 

    Asset Verification System (AVS). (11-5)approved 

    Brokered Non-Emergency Transportation. (10-10) approved 

    Changes to the Medicare Savings Program. (10-20) approved 

    Drug Product Reimbursement. (10-15) approved 

    DSH Pool Modification. (11-10) approved 

    DSH Redistribution. (11-11) Approved 

    EPSDT Blood Lead Investigations. (10-25) submitted 

    Freestanding Birth Centers. (11-03) approved 

    GME Payment Schedule. (10-22) approved 

    Health Care Acquired Conditions & Provider Preventable Conditions. (11-08) approved 

    IPH DRG Reimbursement-Version 28.0 Grouper Rebasing. (11-6) approved 

    Quality Assurance Assessment Program (QAAP) supplement payment reconciliation. (11-09) approved 

    Medicaid Prohibition on Payments to Institutionsor Entities Located Outside of the United States.(11-01) approved 

    Medicaid Recovery Audit Contractor Program. (10-23) approved 

    Reinstatement of Optional Services (Adult Benefit, Low Vision, and Podiatry). (10-24) approved 

    Revised Deemed Newborn Preprint Pages. (10-11) approved 

    Tobacco Cessation Services for Pregnant Women. (11-7) approved 


    Children's Outpatient Hospital Adjustor Pool. (10-04) approved 

    Clarification of Prior Authorization Requirements for Customized Wheelchairs for all Beneficiaries Regardless of Place of Residency. (10-09) approved 

    DSH Pool - Indigent Care Agreement Hospitals. (10-19) approved. 

    Estate Recovery (10-18) approved. 

    Hospital DSH Pools - Small Hospital and Outpatient Uncompensated Care (10-14)approved 

    Hospice Coverage Conditions. (10-06) approved 

    IPH DRG Reimbursement Version 27.0. (10-03) approved 

    Nursing Facilities Complex Care - Rate Determination Conditions (09-18) approved 

    Payment of Pediatric Electrolytes as a Non-Pharmacy Item. (10-08) approved 

    Pharmacy Dispensing Fee Increase And Reimbursement For The Administration Of Vaccines - H1N1 And Seasonal Flu. (09-17) approved 

    Physician Adjustor Program. (10-002) approved 

    Public Clinic Reimbursement (09-13) approved 

    Public Clinic Services-Reimbursement (10-16B) approved 

    Quality Assurance Supplement Payment Reconciliation.(10-17) approved 

    Reduces Provider Fees.(09-20) approved 

    Remove ICF/MR Related Language From the State Plan. Michigan no longer has ICF's. (10-01) approved 

    Reserved Bed Payment - Limitation. (10-07) approved 

    Six Month Home Maintenance Disregard (09-19) approved 

    Tribal Consultation Requirements (10-13) approved 


    AFC/HA Personal Care Services Reimbursement. (08-12) approved 

    Census Income Disregard (08-13) approved 

    Children's Outpatient Hospital Adjustor Pool. (09-12) approved 

    County Medical Care Facilities-Special Payments. (09-06) approved 

    Elimination of Optional Services (09-15) approved 

    GME Innovations Pool Partnership Update (08-02) approved 

    Government Provider DSH Pool (09-11) approved 

    IMD- DSH Pool (09-16) approved 

    IPH - $5 Million DSH Pool (09-04) approved 

    IPH Reimbursement - Version 26.0 Grouper Update (09-01) approved 

    Maternal Infant Health Program (09-07) approved 

    Patient Pay Amounts for Purchase of Non-Covered Services. (09-03) approved 

    Pharmacy Dispensing Fee Increase (09-05) approved 

    Pharmacy Dispensing Fee Decrease (09-14) approved 

    Reimbursement - Hearing Aids Volume Purchase (09-02) approved 

    Reimbursement - Personal Care Serivces (09-08) approved 

    Services/Reimbursement - Special Health Care Needs Facilities (09-09) approved 


    Annual Quality Assurance Supplement Payment Reconcilliation. (08-11) approved 

    Continue Medicaid coverage for children aging out of the Foster Care Program. (07-13)approved 

    Cooperation with Medicaid Integrity Program Efforts. (08-05)approved 

    Drug Product Reimbursement. (07-14)approved 

    EPSDT & Other Medical Care Services Profided by School Districts - Coverage and Reimbursement. (07-03)submitted 

    Estate Recovery (07-21) submitted 

    GME payment schedule (07-10) approved 

    IPH Reimbursement - DRG Rebasing and Grouper 25 Update. (08-03)(Approved) 

    Methods and Standards for Establishing Payment Rates - Inpatient Hospital Care (08-01) submitted 


    Michigan Business Tax name change. (08-04) Approved 

    Nursing Facility QAAP Payments. (07-19) submitted 

    Nursing facility reimbursement-Facility innovative design supplemental program. (07-17)Approved 

    OPHP psoriasis treatment centers. (07-16)approved 

    Pharmacy rebate agreements: incorporating recent modifications to the National Medicaid Pooling Initiative. (07-18) approved 

    Rural Health Clinic Services (07-16)submitted 

    Targeted Case Mangement (08-006)submitted 

    Targeted Case Management 08-007)submitted 

    Targeted Case Management 08-008)submitted 

    Targeted Case Management 08-009)submitted 

    Targeted Case Management 08-010)submitted 


    Allowability of Home Equity Maximum Amounts for LTC Assistance Eligibility.(07-09)Submitted 

    Annual Quality Assurance Supplement Payment Reconcilliation. (07-07) Approved 

    IPH Payment reductions. (07-12) Approved 

    Audiologists - Licensing Requirement. (06-19)Approved 

    Authorization Thresholds-Personal Care Services. (06-22) Approved 

    Children (Income - 150%FPL)(06-23)Withdrawn 

    Eligibility - Transfer of Assets.(07-08) Approved 

    Employee Education - False Claims Act (07-06)Approved 

    ER Co-pay (06-18) Disapproved 

    GME Payment Schedule (07-10)Approved 

    GME Pools (06-21)Approved 

    Inpatient Hospital DSH Pools (07-15)Approved 

    Inpatient Hospital Reimbursement - DRG Grouper (24.0) update(07-04)Submitted 

    Outpatient Hospital Laboratory Services.(07-02)Approved 

    Outpatient Hospital Reimbursement.(06-01)Approved 

    Outpatient Prospective Reimbursement System (OPPS)(07-01) Approved 

    Personal Care Services in the Workplace. (06-16)Approved 

    Pharmacy dispensing fee.(06-13)Withdrawn 

    Prescriptive authority-therapy. (06-17)Approved 

    Requirements for Third Party Liability (07-05)Approved 


    State Laboratory Reimbursement.(06-009)

    Reinserting IPH aproved IPH Reimbursement Language.(06-12)

    MDCH/Office of Administrative Hearing and Rules cooperative agreement.(06-07)approved 

    Eliminates separate Rx coverage in hospital long term care units.(05-20)

    Expand providers eligible to receive reimbursement for Synagis to include enrolled pharmacies.(05-08)

    Expansion of services subject to cost-sharing.(05-14)

    Mail Order Pharmacy Reimbursement(05-03)


    Access To Care - Outpatient Therapy and Audiology Services(05-06)

    Expand Allowable Involuntary Disenrollment Reasons--Effective January 1, 2005(05-01)

    Hearing Aids(04-18)

    Hospital DRG Rebasing(05-10)

    Lab Services and Hearing Aid Reimbursement--Effective January 1, 2005(05-02)

    LIF Eligibility - Asset Disregard(05-04)

    Long Term Care Facility and Hospice Reimbursement for Hospital and Therapeutic Leave Days--Effective Date January 1, 2005(05-07)

    Long Term Care Proportionate Share Pool Payment Sunset Provision(04-12)

    Michigan State Plan Amendment(05-09)

    Nursing Facility Certification(04-19)

    Optional Services(04-15)

    Pharmacy Co-Pay(04-14)

    Presumptive Eligibility for Children and Pregnant Women(05-05)

    Reduction of Pharmacy Dispensing Fee(04-13)

    Vaccine Replacement Program(04-17)


    Inpatient Hospital Reimbursement(04-04)

    MACI (taxi-related payments)(04-05)

    Personal Care Services & Hospital Emergency Services(04-08)

    PACE Capitation Rate Development Procedures(04-11)

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