State Plan Amendments


Inpatient Hospital Capital Reimbursement Methodology.(SPA _15_0001)Submitted 

Inpatient Rate Update - (SPA _15_0002)Approved 

Inpatient Rate Update - Grouper 32.(SPA _15_0002)Submitted 

Ambulatory Surgical Center.(SPA _15_0003)Approved 

Ambulatory Surgical Center.(SPA _15_0003)Submitted 

Indian Health Centers Services.(SPA _15_0004)Submitted 

Indian Health Centers Services.(SPA _15_0005)Submitted 

Outpatient Disproportionate Share Hospital (DSH) Pool Increase.(SPA _15_0006)Submitted 

Outpatient Disproportionate Share Hospital (DSH) Pool Increase Value Based Pool.(SPA _15_0007)Submitted 

Michigan Primary Care Transformation (MiPCT) Project.(SPA _14_0017)Approved 

Michigan Primary Care Transformation (MiPCT) Project.(SPA _14_0017)Submitted 

Primary Care Provider Reimbursement Rate Increase.(SPA _14_0018)Submitted 


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

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

Eligibility Process.(MI 13-0140) Approved 

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

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

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

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 

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

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

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

Ambulatory Surgical Center (ASC).(14-004)Approved 

Inpatient Rate Update to Grouper 31 .(SPA 14-05) Approved 

Federally Qualified Health Center (FQHC) Alternate Payment Methodology.(SPA 14-06) Approved 

Non-emergency medical transportation brokerage contract (NEMT).(SPA 14-007) Approved 

Chronic Care Management for Individuals with Serious and Persistent Mental Health Conditions.(MI 14-0008)Approved 

Medicaid coverage for the working disabled.(SPA 14-009) Approved 

Methodology for Identification of Applicable Federal Medical Assistance Percentage (FMAP)Rates.(SPA 14-10)Submitted 

FY14 Disproportionate Share Hospital (DSH) Pool. (SPA 14-0011) Submitted 

Disproportionate Share Hospital (DSH)Pool - Harper University Hospital. (14-0011) Approved 

Children's Outpatient Hospital Adjuster Pool - Poison Control.(SPA 14-0013) Approved 

Indigent Care Agreement (ICA) DSH Pool Modification(MI 14-0014) Approved 

Indigent Care Agreement (ICA) DSH Pool Modification.(SPA 14-014) Submitted 

Outpatient Therapy Service.(SPA 14-0016)Approved 

Outpatient Therapy Service.(SPA 14-0016)Submitted 

Nursing Facility Rate Relief Eligibility.(SPA 14-015)Submitted 

Outpatient drug coverage changes.(SPA 14-012) Approved 

Coverage for Pregnant Teenagers.(MI 14-0180)Submitted 

State Psychiatric Hospital Reimbursement Methodology.(SPA 14-0019)Submitted 

State Residency.(MI 13-0160) 

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


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) Approved 

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

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

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

Family Planning. (12-04) withdraw  

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 Services (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 Management (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 approved 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)