Facility Interim Rate Claim Adjustment Payments Begin May 18
Providers will see a 2% increase to the current Medicaid interim rate — from 2.5% to 4.5% — retroactively applied to January 1, 2023. The Michigan Department of Health and Human Services (MDHHS) has begun to identify claims with dates of service on or after January 1, 2023, and internally adjust them to process under the increased rate.
Adjusted claims can be identified with the claim note of “Adjusting with updated rate MM” and will begin to appear on the May 18, 2023, remittance advice date, pay cycle 20, until completed.
Providers can view rate notices by accessing MILogin and entering the CHAMPS application. The Provider Rate notice is located under the Archived Documents section under the provider’s National Provider Identification (NPI) number.
As shared previously, Michigan Public Act 5 of 2023, effective March 8, 2023, called for a 2% increase in the nursing facility interim Medicaid rate retroactive to January 1, 2023. The state subsequently submitted a Medicaid state plan amendment (SPA) recognizing this increase to CMS for approval. The SPA was submitted to CMS in March and approved April 21, 2023.
Because MDHHS did not receive CMS approval for the January 1, 2023, 2% rate increase until April, the department approved and paid all previous claims submitted with the provider’s prior rate. The department is now rerunning those claims.
Due to SPA policies during the PHE, there are two state plan amendments addressing the 2% increase to the interim rate between January 1, 2023, and September 20, 2023. The SPA approved April 21 covers January 1, 2023, through May 11, 2023. A second state plan amendment addressing the increase to the interim rate for May 12, 2023, through September 20, 2023, is in process.
Please email any questions regarding your provider specific reimbursement rate calculation notice to LTC Reimbursement and Rate Setting Section.
If you have trouble accessing MILogin or Archived Documents, email Medicaid Provider Support at or call 800-292- 2550.