MDHHS Issues LOCD Unwinding Guidance (SNF/AL)

On March 30, 2023, the Michigan Department of Health & Human Services (MDHHS) issued guidance through this numbered letter, L 23-23, unwinding the Level of Care Determination (LOCD) flexibilities initiated during the Public Health Emergency (PHE). 

The guidance stipulates as of May 12, 2023, providers must resume LOCDs for all beneficiaries. In addition, other clarifications and guidance include a return to in-person LOCD assessments, requirements for documentation to support a beneficiary who may qualify under Door 7, the inactivation of Door 0, and the passive redetermination process will resume generating Door 87s. Providers must conduct an in-person assessment before the end date of Door 87 to determine a beneficiary’s eligibility. In addition, MI Choice and MI Health Link Waivers will not re-establish an enrolled eligibility through Door 8 and approval code 2019. Providers are responsible for monitoring end dates and conducting new LOCDs in a timely manner. 

MDHHS has updated Adequate and Advanced Action Notices. These new forms, along with additional information regarding LOCDs, are available on the MDHHS LOCD website.