The Michigan Department of Health and Human Services (MDHHS) has finalized Medicaid policy updates to the Michigan Mental Health Framework, introducing several changes from the proposed version related to assessment use, timing, and provider eligibility. The updates emphasize clinical decision-making and patient access while establishing new guardrails around standardized assessments.
Assessment and Service Delivery Changes
Under the updated policy, reassessments may now be conducted based on clinical judgment without a defined “change in condition.” Services may be delivered and reimbursed before an assessment is completed, and 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 introduces new guardrails around standardized assessments that signal a shift toward clinical decision-making and patient access. 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.
Provider Eligibility and Age Criteria
The update expands provider eligibility, allowing nonlicensed bachelor’s-level providers to conduct assessments. Age criteria for assessment tools have also been updated. The Level of Care Utilization System now applies to individuals age 18 and older, while MichiCANS applies from birth through age 18. The MDHHS finalized these updates following the proposed version, incorporating feedback and clarifications to strengthen the mental health framework.
This article is an AI-assisted summary. All facts and figures are drawn from the original report: https://www.mha.org/newsroom/mdhhs-finalizes-medicaid-policy-updates-to-mental-health-framework/