Medicare Only Dual Certification – Policy Change Effective 1/1/25, Applications Due 11/18/24 (SNF)
As HCAM previously communicated, the SFY 2025 budget directed the Michigan Department of Health and Human Services (MDHHS) to update Medicaid Policy by easing restrictions on the process for dual certification of Medicare only beds. The previous existing Medicaid policy made it difficult for nursing facilities with Medicare only beds to become dually certified. There were several requirements, including an eight quarter lookback on survey issues, which has limited Medicaid access throughout the state.
The new boilerplate language specifies that the new Medicaid policy must allow for dual certification if the applicant is in substantial compliance at the time of application – this removes the previous restrictions relating to survey history that often prevented dual certification under the current policy.
MDHHS has updated the Medicaid policy as directed by the budget and the change will be effective 1/1/25. Eligible facilities that apply by 11/18/24 will be considered for dual certification effective 1/1/25. Applications received after that date will be considered for 4/1/25 certification.
How to apply for Medicaid bed certification on Medicare only beds:
Submit to LARA at [email protected]:
- BCHS-HFD-100 State Licensure Application 2-9-2016 (michigan.gov)
- Appendix D
- Submit the current and proposed floor plans for the changes being requested. The floor plans must clearly identify each room as either Medicare-Only, Dually Certified, or Licensed-Only.
Providers must simultaneously submit a request to MDHHS Long-Term-Care Policy Section via email at: [email protected]. Please include “Medicaid Bed Designation Request” in the subject line. The request must include BCHS-HFD-100, Appendix D, and current and proposed floor plans (as referenced above).
Providers may apply each quarter and for consideration for 1/1/25 Medicaid certification applications need to be received by November 18, 2024. Applications received this quarter will be reviewed utilizing the new certification criteria as specified in boilerplate. If facilities are in “substantial compliance” they can expect the Medicaid Bed Certifications effective the first day of the next quarter, or January 1, 2025, and will receive a letter confirming same.