UnitedHealthcare Selected to Serve Medicaid Members in Michigan Through the Comprehensive Health Care Program
Eligible adults and children will have access to UnitedHealthcare Medicaid services and benefits in six regions
The Michigan Department of Health and Human Services (MDHHS) has selected UnitedHealthcare Community Plan of Michigan as one of the nine managed care organizations to administer the Comprehensive Health Care Program (CHCP).
The CHCP serves more than 2.1 million Michigan residents, providing health insurance and benefits to low-income Michigan residents, children, pregnant women, seniors and individuals living with disabilities. Through these statewide programs, Medicaid beneficiaries have access to comprehensive services to support their physical and behavioral health, including regular doctor visits, preventive care, screenings, vaccinations, dental check-ups and other critical services.
“We are honored to continue working with our partners at MDHHS to serve the people of Michigan,” said Dennis Mouras, CEO, UnitedHealthcare Community Plan of Michigan. “We are committed to expanding access to high-quality equitable healthcare and working to reduce disparities for the communities we have the privilege to serve.”
The contract, effective October 1, 2024, will allow UnitedHealthcare Community Plan of Michigan to continue serve individuals who qualify for Medicaid through CHCP in regions 4, 6, 7, 8, 9 and 10.
UnitedHealthcare Community Plan of Michigan has provided benefits and care to the people of Michigan for more than 20 years. UnitedHealthcare serves more than 944,000 people enrolled in employer-sponsored, individual, Medicare and Medicaid benefit plans in Michigan, with a network of 151 hospitals, and over 58,900 physicians and other care providers statewide. Currently, UnitedHealthcare, along with its parent company UnitedHealth Group, employs over 3,100 individuals across the state.
UnitedHealthcare Policy and protocol updates for Medicare, Medicaid, Exchanges and commercial.
Click here See the updates
UnitedHealthcare national Gold Card program protocol
Effective Oct. 1, 2024, we will launch a national Gold Card program, which will reward contracted provider groups who consistently adhere to evidence-based care guidelines. The Gold Card program applies to all UnitedHealthcare commercial, Individual Exchange*, UnitedHealthcare® Medicare Advantage and UnitedHealthcare Community Plans.
On Sept. 1, UnitedHealthcare will publish details on how to determine if your provider group has qualified for the program. Additional details about the program will be available on UHCprovider.com and you can review your provider group status in the UnitedHealthcare Provider Portal.
Michigan Medicaid: Treating pregnant individuals and infants
Your patients who are pregnant or have families with infants up to 12 months and are enrolled in Medicaid can receive free services from the Maternal Infant Health Program (MIHP). The services are a supplement to the care you provide and are based on the families’ needs.
The MIHP goal is to support pregnant individuals and babies in areas including:
- Infant health and development
- Nutrition
- Mental health
- Birth and parenting classes
- Housing
- Transportation
Learn more about the services provided and how to refer your patients. See attached flyer.
Outpatient therapy and chiropractic prior authorization requirements
Effective Sept. 1, 2024, we’ll require prior authorization for the following services delivered in multidisciplinary offices and outpatient hospital settings, excluding services in the home:
- Physical therapy (PT)
- Occupational therapy (OT)
- Speech therapy (ST)
- Medicare-covered chiropractic services (when billed with the AT-modifier)
This applies to UnitedHealthcare® Medicare Advantage nationally, excluding Dual Complete Special Needs Plans (SNP).
Please click above link for more information.
Please reserve your spot for UnitedHealthcare Community Plan Virtual Training Session today.
Whether you are new to our network, have new employees, or simply need a refresher, this virtual orientation is designed to give you what you need to get started working with us.
Please click here to sign-up:
At your fingertips: Individual Exchange updates
Access a variety of resources to help you work with us as you care for members who have these state-specific plans.
Individual Exchange Plan Information for Providers | UHCprovider.com
UHC Provider Portal: Upload attachments for professional/institutional claims at submission
Learn how to use Claim Submission to enter claims electronically for professional or facility/institutional claims.
Molecular test registration phase 2 begins on Aug. 1
Beginning on Aug. 1, 2024, you may start registering tests that are in scope for phase 2 of the DEX Z-Codes® for certain molecular diagnostic test services on facility and professional claims. This is part of our recently updated Molecular Pathology Reimbursement Policy, Professional and Facility, which went into effect June 1, 2024.
We previously announced that the requirement for Z-codes to be included on certain molecular diagnostic testing facility and professional claims for the claims to be considered in reimbursement would be launched in phases.
Tests subject to phase 2 will need to include the appropriate Z-code on their claims beginning with dates of service on or after Nov. 1, 2024, to be considered for reimbursement.
We’ll send you reminders about when you should begin registering tests for each phase at least 30 days in advance of the start date of that phase. You may begin registering tests for phase 2 on Aug. 1, 2024.
For further guidance on the timeline for the registration of your tests, view the DEX Diagnostics Exchange test registration and any of the links above.
Focusing on the Needs of Children in the Foster Care System
Health Liaison Officers (HLOs) provide guidance to child welfare staff to meet the health needs of children in foster care.
- HLOs troubleshoot Medicaid coverage issues, health plan coverage and issues with access to community health providers.
- HLOs track compliance with timeliness of medical and dental exams. HLOs are a good resource for any health-related questions.
- HLOs are assigned to a county or number of counties depending on the local/regional population of children in foster care.
- To locate your local HLO click here: https://www.michigan.gov/mdhhs/adult-child-serv/child-welfare-and-well-being/health-and-mental-health-information-and-resources/guides/welfare-profs/where-can-i-find-my-health-liaison-officer-hlo
Reminder: UHC’s Medicaid PCPs can earn a $75 incentive when a foster child has a well visit and mental health screening within 30 days of the child being placed into foster care.
Questions?
Connect with us through chat 24/7 in the UnitedHealthcare Provider Portal.