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June 24 2026 Tribal Health Center Medicare Primary Memo
June 24, 2026: Attention Tribal Health Centers: A memorandum was posted via MiLogin FTS on Wednesday June 3, 2026, indicating a Fee-For-Service claim adjudication error, when the primary payor is Medicare.
Refer below to the Memorandum posted June 3,2026:
It has been discovered that fee-for-service Medicare claims were adjudicating to the Medicaid AIR rate vs the Medicare AIR rate, which is resulting in a takeback at time of settlement.
MDHHS Claims team is updating the claims logic, which is targeted to be implemented by 06-05-2026. This fix is prospective, therefore impacted claims will not be reprocessed.
Any questions regarding this change can be addressed with Adam Wiese at WieseA@michigan.gov