The Michigan Department of Health and Human Services (MDHHS) recently finalized Medicaid policy updates to the Michigan Mental Health Framework, making several changes from the proposed version related to assessment use, timing and provider eligibility.
Reassessments may now be conducted based on clinical judgment without a defined “change in condition.”
Additional clarifications include:
Services may be delivered and reimbursed before an assessment is completed.
Individuals should be assessed when first presenting for services.
A new assessment is not required if one is already on file in the Community Health Automated Medicaid Processing System.
Preadmission screening and Prepaid Inpatient Health Plan processes remain unchanged.
The policy also introduces new guardrails around the use of standardized assessments. Assessments should not be conducted during a crisis and cannot be used to determine, limit or restrict the amount, scope or duration of services. These provisions were not included in the proposed policy and signal a shift toward clinical decision-making and patient access.
The update expands provider eligibility, allowing nonlicensed bachelor’s-level providers to conduct assessments.
In addition, the age criteria for the tools were updated. The Level of Care Utilization System now applies to individuals age 18 and older, while MichiCANS applies from birth through age 18.
Members with questions may contact Lenise Freeman at the MHA.