State Plan Amendment Approved – Michigan Medicaid Releases Rates (SNF)

MDHHS received approval from CMS for their State Plan Amendment (SPA) related to the methodology to calculate the rates for nursing facilities effective October 1, 2021. The approval was made on January 14 and MDHHS released the rates in each provider’s Archived Document folder in CHAMPS.

The rates reflect the policy outlined in L 21-70 issued November 16, 2021 and in the SPA submitted in October 2021 and approved January 2022. The rates reflect an overall interim increase of 2.5% for the both the variable and plant costs from the prior year FY 2021 rate. These are interim rates as the audited costs from your FY 2022 cost reports will be utilized for final rates upon settlement.

Below is the MDHHS notification to all providers regarding these rates.

Medicaid Annual Provider Reimbursement Rates Effective for dates of service on or after October 1, 2021, have been calculated.

• The notices are now available to providers, by accessing MILogin and entering the CHAMPS application. The above reimbursement rate calculation and notice can be located under the “Archived Documents” section for each provider under the provider’s National Provider Identification (NPI) number.
• Trouble accessing MILogin, or Archived Documents please contact Medicaid Provider Support at [email protected] OR call 1 – 800 – 292 – 2550.
• Questions regarding your provider specific reimbursement rate calculation notice should be directed to: LTC Reimbursement and Rate Setting Section at [email protected]
• Due to the Department receiving CMS approval for the modified rate setting process very recently, all claims submitted and approved were paid with the provider’s prior rate. MDHHS Claims Processing will be re-running claims billed for dates of services beginning on/after 10/01/2021 to adjust the amounts paid to providers.

HCAM discussed the timeframe for re-processing these claims and the need for the cash. MDHHS stated they are preparing to re-process 25,000 claims per week so it should be within 2-3 weeks for a facility to receive the rate adjustment funds. Members should not re-run the claims as it will slow down this process and delay payments for everyone. January service dates should pay at the new rate once billed. Questions contact Pat at [email protected] .