Skip to main content

Archived Cost Reporting Forms

PIHP FY19 PIHP Medicaid Utilization and Net Cost Reporting Form for Specialty Services and the Healthy Michigan Plan (HMP) (1/21/2020)

Reporting Instructions for Specialty Services and HMP
Due Date Friday, March 13, 2020, 5:00 p.m.

PIHP Preliminary FY19 PIHP Medicaid Utilization-Only Reporting Form for Specialty Services and the Healthy Michigan Plan (HMP) (12/12/19)

Reporting Instructions for Specialty Services and HMP
Due Date Friday, January 31, 2020, 5:00 p.m.

PIHP 6-Month FY19 PIHP Medicaid Utilization and Cost Reporting Form for Specialty Services and the Healthy Michigan Plan (MHP) (8/13/19)

Reporting Instructions for Specialty Services and HMP
Due Date Monday, September 2, 2019, 5:00 p.m.

CMHSP FY19 Sub-Element Cost Reporting Form and Reporting Instructions (1/21/2020)

Template for CMHSP FY19 Cost Reporting (Oct 2018-Sept. 2019)
Due Date March 13, 2020 5:00 p.m.

CMHSP FY19 General Fund Cost Reporting Form and Reporting Instructions (12/27/2019)

Template for CMHSP FY19 General Fund Cost Reporting (Oct. 2018 - Sept. 2019)
Due Date March 13, 2020 5:00 p.m.

CMHSP FY18 Sub-Element Cost Reporting Form and Reporting Instructions
(UpLess...dated: 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.