Mental Health & Substance Abuse Reporting Requirements
In order to monitor service provision, expenditures and consumer outcomes, the Department requires Community Mental Health Services Providers (CMHSPs), and Pre-Paid Inpatient Health Plans (PIHPs) to provide information and data on topics such as costs, services, consumer demographics, and administrative activities. The following is a list of key instructional documents for reporting to the federal Substance Abuse and Mental Health Services Administration.
(Click here for data reports and statistics.)- Link to Core HIPAA-Related Health Plan Materials
- PIHP/CMHSP Encounter Reporting Costing Per Code and Code Chart (Updated 07/15/2019)
- PIHP/CMHSP Provider Qualifications Chart (Updated 7/1/19)
- Michigan Fidelity Assistance Support Team (MIFAST)
Administrative Cost Reporting - Forms and Instructions
Administrative Cost Reporting Fiscal Year 2018
Forms and Instructions Revised and Posted for FY18 Expenditures per FY18 General Fund Contract Section 7.8 & 7.8.1.
(Last Updated 02/14/2019)Administrative Cost Reporting Fiscal Year 2017
Forms and Instructions Revised and Posted for FY 17 Expenditures per FY17 General Fund Contract Section 7.8 & 7.8.1.
(Last Updated 02/10/2018)Administrative Cost Reporting Fiscal Year 2016
Forms and Instructions Revised and Posted for FY 16 Expenditures per FY16 General Fund Contract Section 7.8 & 7.8.1.
(Last Updated 02/10/2017)Administrative Cost Reporting Fiscal Year 2015
Forms and Instructions Revised and Posted for FY 14 Expenditures per FY15 General Fund Contract Section 7.8 & 7.8.1
(Last Updated 02/04/2015)- Previous Years 2009 - 2014
Medical Loss Ratio Reporting - Forms and Instructions
Medical Loss Ratio Reporting State Fiscal Year 2018
Forms and Instructions Posted for FY18 Expenditures per FY18 General Fund Contract Section 7.8 & 7.8.1.
(Last Updated 02/14/2019)
Annual Submission Requirement Forms and Instructions
- Annual Submission Requirement Instructions
- Estimated FTEs Equivalents
- Request for Service and Disposition of Requests
- Waiting List
- Needs Assessment Guidelines (Last updated 1/16/2018)
Submission deadline extended to March 28, 2019
Financial Status Reporting
Financial Status Reporting Fiscal Year 2019
Contract Requirements Per General Fund Section P6.5.1.1 and Medicaid Section P7.7.1.1
(Medicaid contract amendment #3)Financial Status Reporting Fiscal Year 2018
Contract Requirements Per General Fund Section P6.5.1.1 and Medicaid Section P7.7.1.1
(Medicaid contract amendment #2 effective 6/1/2018)Financial Status Reporting Fiscal Year 2017
Contract Requirements Per General Fund Section P6.5.1.1 and Medicaid Section P7.7.1.1
Last updated 12/01/2017Financial Status Reporting Fiscal Year 2016
Contract Requirements Per General Fund Section P6.5.5.1 and Medicaid Section P7.7.1.1
Last updated 5/11/2016-
Previous Years FY2009 - FY2015
SUD (Non-Medicaid) Reporting Instructions and Forms
PIHP SUD Reporting for FY 2020
Contract Requirements Per Medicaid Section 7.7.1.1
- Reporting Index V-2020 - Forms and Instructions
PIHP SUD Reporting for FY 2019
Contract Requirements Per Medicaid Section 7.7.1.1
- Reporting Index V-2019 - Forms and Instructions
PIHP SUD Reporting for FY 2018
Contract Requirements Per Medicaid Section 7.7.1.1
(Medicaid contract amendment #2 effective 6/1/2018)- Reporting Index V-2018-1 - Forms and Instructions
Contract Requirements Per Medicaid Section 4.13.1.
- ROSC/Recovery Process Deadlines:
Table 2 Annual Planning Matrices - 12/31/17
Table 3a or 3b Annual Survey Information Forms for FY17 and FY18 (separately) - 10/31/2018
Table 2 Annual Reporting Matrices - 02/28/19PIHP SUD Reporting for FY 2017
Contract Requirements Per Medicaid Section 7.7.1.1
(Last Updated 02/22/2017)Contract Requirements Per Medicaid Section 4.13.1.
- ROSC/Recovery Process Deadlines
Table 2 Annual Planning Matrices - 12/31/16 (due date extended to 3/31/17)
Table 3a or 3b Annual Survey Information Forms for FY17 and FY18 (separately) - 10/31/18
Table 2 Annual Reporting Matrices - 02/28/18PIHP SUD Reporting for FY 2016
Contract Requirements Per Medicaid Section 7.7.1.1
(Last Updated 9/30/2015)PIHP SUD Reporting for FY 2015
Contract Requirements Per Medicaid Section 7.8.1
(Last Updated 9/25/2014)
Performance Bonus Incentive
- Performance Bonus Joint MHP/PIHP Metrics
- PIHP-only Pay for Performance Measures
Medicaid Hospital Rate Adjustment (HRA) Annual Report
Medicaid Hospital Rate Adjustment (HRA) Annual Report
FY2017
NOTE: In order to comply with the new CMS Managed Care rules on pass through payments, MDHHS is changing the basis of allocations from cost reports to encounters.
PIHPs are not required to submit HRA Annual cost reports for FY2017.
FY2016
- Contract Requirements Per Medicaid Section 7.7.1.1 (Last Updated 04/12/2016)
- FY16 Medicaid Hospital Costs - Instructions
- Medicaid Hospital Spending FY16 for HRA FY18
- Previous Years 2010-2015
BH - TEDS
- BH-TEDS FY 19 File Specifications
Rev. 01/29/2019
- Field Requirements - Color Coded
Rev. 10/19/2017
- BH-TEDS Q & A
Rev. 9/16
- BH-TEDS Error Logic
- BH-TEDS Coding Instructions FY19 Rev. 10/17/2018
- BH-TEDS Error Description
Rev. 10/1/2018
Please send all questions and comments to Carol Hyso at HysoC@michigan.gov.
BH - REGISTRY FILE
- BH - Registry File Process Documentation
Please send all questions and comments to Dick Berry at BerryR3@michigan.gov.
DD Proxy Measures
CMHSP/PIHP MDHHS Systems List
- CMHSP/PIHP MDHHS Systems List
Many data systems are required in order to satisfy MDHHS reporting requirements. The "CMHSP/PIHP MDHHS Systems List" identifies how to add, change, or inactivate user accounts for systems that BHDDA requires the CMHSPs and PIHPs to use for reporting.
If you have questions or comments, contact Jackie Sproat at sproatj@michigan.gov.
Instructions for Reporting Financial Information - 837 Encounters
- LARA License Reporting
- Instructions for Reporting Financial Information (Updated: 04/22/2013)
Documentation on how to report financial information via the 837 including charged and paid amount, and provider identification.
PIHP and CMHSP Cost Reporting Forms
-
Reporting Instructions for Specialty Services and HMP
Due Date Monday, September 2, 2019, 5:00 p.m.
PIHP Preliminary FY18 Medicaid Utilization and Cost Reporting Form for Specialty Services, and the Healthy Michigan Plan (HMP) (Updated: 1/16/2019)
Reporting Instructions for Specialty Services and HMP
Due date January 31, 2019 5:00 p.m.
Reporting Instructions for Specialty Services and HMP
(Updated: 02/19/2019)
Due date February 28, 2019 5:00 P.M.
CMHSP FY18 Sub-Element Cost Reporting Form and Reporting Instructions
(Updated: 01/03/2019)Template for CMHSP FY18 Cost Reporting. (Oct 2017-Sept 2018)
Due date February 28, 2019 5:00 P.M.CMHSP FY18 General Fund Cost Reporting Form and Reporting Instructions (Updated: 01/03/2019)
Template for CMHSP FY18 General Fund Cost Reporting (Oct 2017-Sept 2018).
Due date February 28, 2019 5:00 P.M.
PIHP and CMHSP Performance Indicator Systems
Michigan's Mission-Based Performance Indicator System, Ver. 6.0 (Updated: 12/18/2013)
Detailed instructions for reporting the Performance Indicators. Includes codebooks. Required for PIHPs and CMHSPs.
CMHSP Template (Updated: 11/14/2017)
PIHP Template (Updated: 11/14/2017)
Network Adequacy Standards
Other Resources
- Instructions for Generating a CAFAS® and PECFAS® Aggregate Reports (Updated: 11/21/2013)
Instructions for generating aggregate annual Child and Adolescent Functional Assessment Scale (CAFAS) and Pre-School and Early Childhood Functional Assessment Scale (PECFAS) reports.
- MDCH/PIHP Event Reporting FY11 (Updated: 11/01/2010)
Documentation on how to report to the Event Reporting System. Includes requirements, coding instructions, technical specification and the Implementation Guide. Current reporting includes suicides, non-suicide deaths, emergency medical treatment due to injury or medication error, hospitalizations due to emergency or medication error, and arrests for reportable populations .
- PIHP/CMHSP Encounter Reporting Costing Per Code and Code Chart (Updated: 07/15/2019)
Includes all reportable HCPCS and Revenue codes for mental health. Contains updated instructions on use of modifiers and the acceptable activities that may be reflected in the cost of each procedure such as whether an activity needs to be face-to-face.
- NPI Reporting Guidelines for 837 Encounter Transactions (Updated: 06/10/2016)
Includes all reportable HCPCS and Revenue codes for mental health. Contains updated instructions on use of modifiers and the acceptable activities that may be reflected in the cost of each procedure such as whether an activity needs to be face-to-face.
- Private Duty Nursing Authorizations Manual (Updated: 08/25/2010)
The User Manual guides CMH staff who are authorized through CHAMPS to enter prior authorizations for private duty nursing.
If you have questions on this material, please e-mail Kathy Haines at HainesK@michigan.gov.