Updates to Nursing Facility Providers Level of Care Determination (LOCD) Door 0 Claims Process (SNF)

During the COVID-19 public health emergency (PHE), providers were instructed to not to create Door 0 Level of Care Determinations (LOCDs) in the Community Health Automated Medicaid Processing System (CHAMPS) if there was an existing eligible LOCD in CHAMPS for a beneficiary. With the termination of the PHE, the Michigan Department of Health and Human Services (MDHHS) is resuming its LOCD policy as stated in the MDHHS Medicaid Provider Manual. This detailed document provides guidance for SNFs that are requesting claims for beneficiaries under Numbered Letter L 20-59 as well as information on how to request Fee-for-Service (FFS) claims payments for admitted Door 0 beneficiaries post-PHE.