MDHHS Provides Long-Term Care Reimbursement and Audit Updates (SNF)

FY 26 Medicaid Rates (10/1/2025): The Michigan Department of Health and Human Services (MDHHS) has accepted all cost reports and received the federal market basket data to set the CAV limit and rates. The department is currently working on FY 26 rates and will have them completed once the state budget is finalized. In addition, the department will keep the current FY 25 Medicaid rates in place until the budget is finalized, with retroactive application of the new rate.

FY 26 Direct Care Worker Wage Rates: The House, Senate and governor’s budget all continue the DCW at current levels ($3.40 for direct care workers, $0.85 for non-direct care workers). This is a strong indication that the DCW is likely to continue when the current fiscal year ends September 30, 2025. HCAM continues to seek clarity from MDHHS on how to process DCW reimbursements in the event of a budget impasse after October 1.  

Quality Assurance Supplement (QAS) Reconciliations: The annual QAS reconciliation process is moving from January to November. Providers are asked to bill September claims early in October to be included in the November reconciliations. The process will remain the same, including three-year reconciliations, notifications and placement in FileNet.

Partnership Meeting: A monthly meeting of MDHHS, long-term care providers, partners and stakeholders occurs every third Monday from 2-3 pm. Email K. Kelly if you would like to be included in the meetings or have agenda items you would like to discuss.