Behavioral and Physical Health and Aging Services Administration, Immunization Info for Families & Providers, Michigan Maternal Mortality Surveillance Program, Informed Consent for Abortion for Patients, Informed Consent for Abortion for Providers, Go to Child Welfare Medical and Behavioral Health Resources, Go to Children's Special Health Care Services, General Information For Families About CSHCS, Go to Emergency Relief: Home, Utilities & Burial, Supplemental Nutrition Assistance Program Education, Go to Low-income Households Water Assistance Program (LIHWAP), Go to Children's & Adult Protective Services, Go to Children's Trust Fund - Abuse Prevention, Bureau of Emergency Preparedness, EMS, and Systems of Care, Division of Emergency Preparedness & Response, Infant Safe Sleep for EMS Agencies and Fire Departments, Go to Adult Behavioral Health & Developmental Disability, Behavioral Health Information Sharing & Privacy, Integrated Treatment for Co-occurring Disorders, Cardiovascular Health, Nutrition & Physical Activity, Office of Equity and Minority Health (OEMH), Communicable Disease Information and Resources, Mother Infant Health & Equity Improvement Plan (MIHEIP), Michigan Perinatal Quality Collaborative (MI PQC), Mother Infant Health & Equity Collaborative (MIHEC) Meetings, Go to Birth, Death, Marriage and Divorce Records, Child Lead Exposure Elimination Commission, Coronavirus Task Force on Racial Disparities, Michigan Commission on Services to the Aging, Nursing Home Workforce Stabilization Council, Guy Thompson Parent Advisory Council (GTPAC), Strengthening Our Focus on Children & Families, Supports for Working with Youth Who Identify as LGBTQ, Go to Contractor and Subrecipient Resources, Civil Monetary Penalty (CMP) Grant Program, Nurse Aide Training and Testing Reimbursement Forms and Instructions, MI Kids Now Student Loan Repayment Program, Michigan Opioid Treatment Access Loan Repayment Program, MI Interagency Migrant Services Committee, Go to Protect MiFamily -Title IV-E Waiver, Students in Energy Efficiency-Related Field, Go to Community & Volunteer Opportunities, Go to Reports & Statistics - Health Services, Other Chronic Disease & Injury Control Data, Nondiscrimination Statement (No discriminacion), 2022-2024 Social Determinants of Health Strategy, Go to Reports & Statistics - Human Services. Home to an array of public health programs, initiatives and interventions aimed at improving the health and well-being of women, infants, families and communities. Information on treatment and services for juvenile offenders, success stories, and more. You may submit the request by mail, fax, or e-mail to one of the following: MDHHS/Medicaid Program Policy Division It is important that pregnant women get proper dental care during their pregnancy for the health and wellbeing of the mother and infant. Benefit plan data is assigned by the CHAMPS Eligibility and Enrollment (EE) Subsystem based on the source of the data (e.g., Medicaid, CSHCS, etc.) Birth, Death, Marriage and Divorce Records. Children's Special Health Care Services information and FAQ's. Michigan has accepted federal Medicaid expansion 2,901,288 - Number of Michiganders covered by Medicaid/CHIP as of March 2022 989,279 - Increase in the number of Michiganders covered by Medicaid/CHIP fall 2013 to March 2022 53% - Reduction in the uninsured rate from 2010 to 2019 stream Additional Guidance and Clarification for the Coverage of COVID-19 Prevention, Treatment, and Support Services. A Non-Government Resource For Healthcare All Rights Reserved 2023. The request must include a company/facility name and address, National Provider Identifier (NPI) (if applicable), telephone number, and a contact person's name. Information on treatment and services for juvenile offenders, success stories, and more. Resources and information to assist in assuring firearm safety for families in the state of Michigan. Information on How to Bid, Requests for Proposals, forms and publications, contractor rates, and manuals. Equal Opportunity, Legal Base, Laws and Reporting Welfare Fraud information. 3 0 obj The Henry J. Kaiser Family Foundation Headquarters: 185 Berry St., Suite 2000, San Francisco, CA 94107 | Phone 650-854-9400 Washington Offices and Barbara Jordan Conference Center: 1330 G Street . Prevention of diseases & conditions such as heart disease, cancer, diabetes and many others. Health Care Coverage information and resources. Gretchen Whitmer's 2022-23 budget proposal, unveiled this week, is good news for dentistry and the oral health of Michiganders. For Microsoft Edge enable Adobe flash player. A report released in January from George Washington University found that up to 2.5 million patients of community health centers, which treat both underserved rural and urban communities, could lose coverage as a result of eligibility redeterminations, costing the health centers somewhere from $1.5 billion to $2.5 billion in revenue. Information on Safe Sleep for your baby, how to protect your baby's life. These services are optional, so any state can change the rules that govern coverage, which dental services are included with routine care, and who can qualify for those services based on income, age and other demographic factors. Please update to a modern browser such as Chrome, Firefox or Edge to experience all features Michigan.gov has to offer. For Notices of Proposed Policy, click here. Please select one of the states in which Molina Healthcare provides services. Medicaid is health insurance across the nation, which means all eligible citizens might enjoy advantages for medically required assistance. information about the Department's public safety programs. and program assignment factors (e.g., scope/coverage codes, etc. Equal Opportunity, Legal Base, Laws and Reporting Welfare Fraud information. Information on DHS Applications and Forms grouped by category. Michigan Medicaid Provider Manual >> Dental Chapter >> Section 2.1 Prior Authorization Requirements in Cases of Misutilization Providers Medicaid 2022 Medicaid Policy Bulletins This page contains policy bulletins issued in 2022. Delta Dental is one of the Healthy Michigan Plan's benefit administrators. You can contribute up to $3,650 for single coverage or $7,300 for family coverage in 2022, plus $1,000 in catch-up contributions if you're 55 or older. Meaning children with Medicaid must receive dental care that provides the following: Regular dental care maintenance, including teeth cleanings and checkups Tooth restorative care Adult Behavioral Health & Developmental Disability Services. To acquaint yourself with this manual, begin with the Medicaid Provider Manual Overview. Michigan Medicaid uses a managed care system to deliver medical and dental care, and the Medicaid dental benefit is carved out and administered by various dental plans contracted by the state. It outlines everything you need to know about your Molina Healthcare of Michigan Medicaid Health Plan. There are two coverage options: Pediatric-only coverage: Required by the Affordable Care Act if you have children age 18 or under. 1 0 obj However, if you decide to print, it is suggested printing be limited to only those chapters relevant to your practice or interest, and that printing be done in black and white. Information on the Safe Delivery Program, laws, and publications. Equal Opportunity, Legal Base, Laws and Reporting Welfare Fraud information. Information on adoption programs, adoption resources, locating birth parents and obtaining information from adoption records. Together, they provide a network of dentists for children ages 0-20. Prior authorizations and medical conditions that may bypass these requirements, To request or view upcoming training sessions please refer to the Michigan Department of Health and Human Services website at, Any questions should be directed to Provider Inquiry, Michigan Department of Health and Human Services, phone toll-free 800-292-2550 or email at, Behavioral and Physical Health and Aging Services Administration, Immunization Info for Families & Providers, Michigan Maternal Mortality Surveillance Program, Informed Consent for Abortion for Patients, Informed Consent for Abortion for Providers, Go to Child Welfare Medical and Behavioral Health Resources, Go to Children's Special Health Care Services, General Information For Families About CSHCS, Go to Emergency Relief: Home, Utilities & Burial, Supplemental Nutrition Assistance Program Education, Go to Low-income Households Water Assistance Program (LIHWAP), Go to Children's & Adult Protective Services, Go to Children's Trust Fund - Abuse Prevention, Bureau of Emergency Preparedness, EMS, and Systems of Care, Division of Emergency Preparedness & Response, Infant Safe Sleep for EMS Agencies and Fire Departments, Go to Adult Behavioral Health & Developmental Disability, Behavioral Health Information Sharing & Privacy, Integrated Treatment for Co-occurring Disorders, Cardiovascular Health, Nutrition & Physical Activity, Office of Equity and Minority Health (OEMH), Communicable Disease Information and Resources, Mother Infant Health & Equity Improvement Plan (MIHEIP), Michigan Perinatal Quality Collaborative (MI PQC), Mother Infant Health & Equity Collaborative (MIHEC) Meetings, Go to Birth, Death, Marriage and Divorce Records, Child Lead Exposure Elimination Commission, Coronavirus Task Force on Racial Disparities, Michigan Commission on Services to the Aging, Nursing Home Workforce Stabilization Council, Guy Thompson Parent Advisory Council (GTPAC), Strengthening Our Focus on Children & Families, Supports for Working with Youth Who Identify as LGBTQ, Go to Contractor and Subrecipient Resources, Civil Monetary Penalty (CMP) Grant Program, Nurse Aide Training and Testing Reimbursement Forms and Instructions, MI Kids Now Student Loan Repayment Program, Michigan Opioid Treatment Access Loan Repayment Program, MI Interagency Migrant Services Committee, Go to Protect MiFamily -Title IV-E Waiver, Students in Energy Efficiency-Related Field, Go to Community & Volunteer Opportunities, Go to Reports & Statistics - Health Services, Other Chronic Disease & Injury Control Data, Nondiscrimination Statement (No discriminacion), 2022-2024 Social Determinants of Health Strategy, Go to Reports & Statistics - Human Services. We believe you will find the format and search capabilities of this Manual to be user-friendly and having all policies in a single document very convenient. To find out more about Healthy Kids Dental, the dental benefits your child may be eligible to receive and to locate a dentist in your area, please visit www.healthykidsdental.org. Updated October 20, 2022. MIChild is a health care program for children who are under age 19 administered by the Michigan Department of Health and Human Services. PWD uses the Healthy Michigan Plan dental benefits and network, and provides dental benefits for women for the duration of their pregnancy, as well as the 12-month period following the due date. member handbook, Healthy Michigan Plan EPO network member handbook. MDHHS News, Press Releases, Media toolkit, and Media Inquiries. November 22, 2022: Michigan Medicaid Coverage of the National Diabetes Prevention Program: Tribal Chairs and Health Directors: L 22-64: November 15, 2022: . If you are using a dial-up modem, we recommend you use the CD version of the Manual. Enroll in the Enhanced Dental and Vision package today. Information on Adult Protective Services, Independent Living Services, Adult Community Placement Services, and HIV/AIDS Support Services. Information on the Family Independence Program, State Disability Assistance, SSI, Refugee, and other cash assistance. Information on resources in your community and volunteer recruitment and training, and services provided at local DHS offices. Please update to a modern browser such as Chrome, Firefox or Edge to experience all features Michigan.gov has to offer. Two options: MyPriorityDelta Dental Standard and MyPriorityDelta Dental Enhanced (includes ortho coverage) Preventive covered at 100% immediately - no waiting period Michigan Medicaid - Michigan Dental Association Michigan Medicaid Home Government/Insurance/Advocacy Dental Benefits Michigan Medicaid Member's Only Content You must be a member to view this content. We are also ramping up our efforts to educate consumers, health care providers and the public about positive oral health practices. According to the American Dental Association, 36% of lower-income Americans have lived through untreated cavities. The COVID public health emergency (PHE) is expected to be extended again in January 2023, but the omnibus bill de-links the resumption of Medicaid eligibility redeterminations from the PHE, and allows states to start . Michigan Medicaid covers limited dental services for adults, including dental check-ups, teeth cleaning, X-rays, fillings, tooth extractions, and dentures. For Government Resources Regarding Medicare, Please Visit www.medicare.gov. ; Take your Health Plan card and mihealth card with you when you visit the doctor, pharmacy, hospital or other medical provider. Information about audits conducted by the Office of Audit. Once you find a dentist, call and make an appointment. Adult Behavioral Health & Developmental Disability Services. Information & resources for Community and Faith-Based partners. Clarification of Michigan Automated Prescription System (MAPS) Record Retention, Postpartum Extension from 60 Days to 12 Months, COVID-19 Response: Policy for COVID Relief (CR) Facilities to Treat COVID-19 Residents Requiring Nursing Facility (NF) Care in Limited Circumstances, Durable Medical Equipment and Supplies Providers. Children's Special Health Care Services information and FAQ's. ; Your Provider will use your Health Plan card and mihealth card to . <>/XObject<>/Font<>/ProcSet[/PDF/Text/ImageB/ImageC/ImageI] >>/MediaBox[ 0 0 960 540] /Contents 4 0 R/Group<>/Tabs/S/StructParents 0>> Please visit MyMolina.com if you would like to review your healthcare coverage. Full dual-eligibility may grant recipients access to routine dental care and some emergency or restorative procedures with prior authorization. Molina Healthcare will provide the names of participating dentists in their area who are available to provide dental services. Legislation policy and planning information. Pregnant Medicaid members will get dental coverage from the first day of the month when Molina finds out about the pregnancy through the postpartum period. Information on the grant awarded for the State Innovation Model Proposal, Offers resources for agencies who operate the Weatherization Assistance Program in the state of Michigan. Children's Special Health Care Services information and FAQ's. Call Michigan ENROLLS at (888) 367-6557. Information is collected to monitor the general health and well-being of Michigan citizens. Be sure to tell the dental office that you are a Medicaid member. Learn more about the Michigan UnitedHealthcare Community Plan plan for Michigan. Michigan Medicaid does have benefits that will cover adults through its Healthy Michigan plan. Please identify the project number of the proposed Medicaid policy or consultation summary if known. Programs for healthy children & families, including immunization, lead poisoning prevention, prenatal smoking cessation, and many others. 5 0 obj Gov. Health Care Coverage information and resources. The electronic Medicaid Provider Manual contains coverage, billing, and reimbursement policies for Medicaid, Healthy Michigan Plan, Children's Special Health Care Services, Maternity Outpatient Medical Services (MOMS), and other healthcare programs administered by the Michigan Department of Health and Human Services (MDHHS). The recommended web browser to open the Medicaid Provider Manual is Microsoft Edge, Mozilla Firefox, Google Chrome, and Microsoft Explorer 11. The request must include a company/facility name and address, National Provider Identifier (NPI) (if applicable), telephone number, and a contact person's name. Home to an array of public health programs, initiatives and interventions aimed at improving the health and well-being of women, infants, families and communities. Molina Dental Services under Medicaid isprovided to members at no cost. Fees payable to providers by Medi-Cal Dental for covered services shall be the LESSER of: a. provider's billed amount b. the maximum allowance set forth in the schedule below 2. A smaller zipped copy(14MB) is also available. Inability to access dental care can result in poor oral health. [6] For pregnant women, oral health complications are associated with poor pregnancy outcomes like low birth weight and preterm birth.State Medicaid programs are required to cover dental services for children under 21, but services for adults, including pregnant women, are optional. The Qualified Medicare Beneficiary (QMB) program provides Medicare coverage of Part A and Part B premiums and cost sharing to low-income Medicare beneficiaries. However, after the passing of the Affordable Care Act, states can now extend those original benefits to offer more healthcare to a larger group of its residents. Universal caseload, or task-based processing, is a different way of handling public assistance cases. Click here to view HKD program information. The least costly alternative rule concerns . On For more information, or to find out how to get enrolled, please contact Meridian at 888-437-0606. The program focuses on prevention, early diagnosis, and treatment of medical conditions. The Michigan Department of Health and Human Services' (MDHHS) Division of Environmental Health (DEH) uses the best available science to reduce, eliminate, or prevent harm from environmental, chemical, and physical hazards. Catching a Breath Complex Case Management Flu Outreach Opioids Rescue Inhaler Overutilization Risk for Kidney Failure Smoking Cessation Transition of Care Call Member Services at 888-437-0606 (TTY: 711) memberservices.mi@mhplan.com How to enroll. ), Archived Proposed Medicaid Policy Distributed for Public Comment and Consultation Summaries. Legislation policy and planning information. <> The overall average rate change for individual/family health coverage is a 5.5% increase for 2023. Bridge Card Participation Information on Electronic Benefits for clients and businesses, lists of participating retailers and ATMs, and QUEST. Information on treatment and services for juvenile offenders, success stories, and more. POL establishes referral mechanisms between medical and dental practices within a community for infant oral health. The Michigan Domestic & Sexual Violence Prevention and Treatment Board administers state and federal funding for domestic violence shelters and advocacy services, develops and recommends policy, and develops and provides technical assistance and training. endobj Prevention of diseases & conditions such as heart disease, cancer, diabetes and many others. We do not offer every plan available in your area. Information about audits conducted by the Office of Audit. We appreciate your feedback about our website. Benefits are provided only in nursing homes. All statesincluding the District of Columbiaprovide data each month about their Medicaid and Children's Health Insurance Programs (CHIP) eligibility and enrollment activity. Information on the Safe Delivery Program, laws, and publications. The Michigan Domestic & Sexual Violence Prevention and Treatment Board administers state and federal funding for domestic violence shelters and advocacy services, develops and recommends policy, and develops and provides technical assistance and training. Licensing information for Adult Foster Care and Homes for the Aged, Child Day Care Facilities, Child Caring Institutions, Children's Foster Care Homes, Child Placing Agencies, Juvenile Court Operated Facilities and Children's or Adult Foster Care Camps. The Overview describes how information is organized and how to navigate through the document. The low percentage of participation of Americans in Medicaid may be due to the facts that: Join or renew membership today by calling 800-589-2632 or apply online. Information on communicable & chronic diseases. Medicare.Org Is Privately Owned And Operated By Health Network Group, LLC. One is the normal Medicaid plan and the second is MIChild. Refer to your Medi -Cal Dental Provider Handbook for specific procedure . Adult Behavioral Health & Developmental Disability Services. Some of the common procedures of Medicaid coverage for adults in 2022 are: Each state has specific regulations about which dental specialty areas they possess. SPOTLIGHT & RELEASES. A variety of reports & statistics for programs and services. Low-income Households Water Assistance Program (LIHWAP). Find a dentist, review benefits, download or print an ID card, and much more through Member Portal, available 24/7. To be eligible, you must have an annual household income (before taxes) that is below the following amounts: Select Household Size Maximum Household Income per year If you would like to view historical versions of proposed Medicaid policy that were released for public comment or you would like to obtain a consultation summary of any bulletin, e-mail msadraftpolicy@michigan.govwith your request. ). CMS approved the Healthy Michigan demonstration that allows the state to require premiums (not to exceed 2 percent of the individual's income) for New Adult beneficiaries with incomes over 100 percent of the FPL, and copayment liability (if applicable) for all New Adult beneficiaries 0-133 percent of the FPL billed on an aggregated basis after the first six months of enrollment. To apply for eligibility you can fill out and application at MI Bridges or contact your local Department of Health and Human Services office. Pregnant Medicaid members are able to use their Molina Healthcare Medicaid ID card to obtain dental services. Pregnant Women Dental (PWD) is an enhanced dental benefit for pregnant women enrolled in Medicaid and is provided by Delta Dental of Michigan and the Michigan Department of Health and Human Services. New Family Planning Eligibility Group, COVID-19 Response: Application Period for COVID Relief (CF) Facilities to Treat COVID-19 Residents Requiring Nursing Facility (NF) Care in Limited Circumstances, Submission of a State Plan Amendment (SPA) Request for the Home Help Program, Temporary Rate Increases for Incontinence Volume Purchase Contract, Non-routine Therapy Prior Authorization Requirements for Nursing Facility Residents, Michigan's Revised Statewide Transition Plan for Home and Community-Based Services Waiver Programs, Early and Periodic Screening, Diagnosis and Treatment (EPSDT) Dental Periodicity Schedule, Coordination of Benefits for MI Choice services for participants who receive services for accidental bodily injury covered by personal injury protection (PIP) insurance through an automobile insurance company, COVID-19 Response: Updates to Bulletins MSA 20-76, MSA 21-43 and HASA 22-04, Nursing Facility Quality Measure Initiative Resident Satisfaction Survey Data, Notice of Intent to Submit a Section 1915(b) Waiver Renewal Application for the Healthy Kids Dental Program, Michigan Department of Health and Human Services (MDHHS) Request for comment on Behavioral Health Home and Community-Based Services (HCBS) for Heightened Scrutiny (HS) settings within the Ten Prepaid Inpatient Health Plan (PIHP) Regions, Medicaid Reimbursement for Vaccine Administration Services, Notice of September 14, 2022, Durable Medical Equipment and Supplies Medicaid Provider Liaison Meeting, Request for Comment on Home and Community-Based Settings for Mi Choice Waiver Program, Michigan Department of Health and Human Services (MDHHS) Request for Comment on Home and Community-Based Settings for MI Choice Waiver Program, Clarification of Pharmacy Professional Dispensing Fees for COVID-19 Home Tests, Medicaid Coverage and Reimbursement of COVID-19 Testing and Treatment Services under the American Rescue Plan Act of 2021, Update to Emergency Medical Services Delivery of COVID-19 Related Services, Notice of June 15, 2022 Durable Medical Equipment and Supplies Medicaid Provider Liaison Meeting Notice, Attending Provider Field on the Institutional Hospital Claim Format, Home Help Agency Caregiver Wage Increase Requirements for Unapproved Home Help Agency Providers, Changes to Quality Assurance Supplement (QAS) Calculation and Payment Methodology for MI Health Link (MHL) for Calendar year (CY) 2022, Changes to the Quality Assurance Supplement (QAS) Calculation and Payment Methodology for MI Health Link (MHL) for Calendar Year (CY) 2022, Lead in Water Removal of Galvanized Plumbing and Blood Lead Reference Value Change State Plan Amendment (SPA) Request, Public Comment on Heightened Scrutiny Settings for Region 5-Mid-State Health Network, CMHSPs, PIHPs, Wraparound Services Providers, Guide to Distributing and Documenting Mandated Home Help Agency Caregiver Pay Increases, Direct Care Worker Premium Pay for April 1, 2020 through September 30, 2021, MI Choice Agencies, PIHPs/CMHSPs, Wraparound Services Providers. 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