MDHHS Clarifies Policy to Enter Level of Care Determinations into CHAMPS

The Michigan Department of Health and Human Services (MDHHS) has received an increasing number of reporting discrepancies with Level of Care Determinations (LOCD) records for admitted or enrolled beneficiaries. These issues occur when providers fail to enter LOCDs into the Community Health Automated Medicaid Processing System (CHAMPS).

MDHHS issued Numbered Letter L 25-24-LOCD to clarify the policy. Per the MDHHS Medicaid Provider Manual, LOCDs must be “entered into CHAMPS to be considered valid for establishing functional eligibility” for Medicaid reimbursed long- term care supports and services. CHAMPS is defined as the production environment used as the database of record for the State Medicaid Agency.

Please note: LOCDs entered in another site, electronic record management system or testing environment such as CHAMPS B2B are not valid for payment, eligibility determinations or involuntary discharge purposes. Providers are responsible for ensuring they access the correct CHAMPS environment when entering a LOCD. Failure to do so may result in a denial of payment, and these costs cannot be passed on to the beneficiary. Incorrectly submitted LOCDs must be emailed to Provider Support by June 27, 2025, for review and possible correction. After June 27, 2025, no further corrections will be made for this issue.