Newsletter August 2025
Amanda Ittner, MBA
Deputy Director
NEW Medicaid Program - MI Coordinated Health
In 2022, the Centers for Medicare & Medicaid Services (CMS) released a final rule, CMS 4192-F, that
significantly impacted Michigan’s MI Health Link (MIHL) program. Under the rule all State Medicare-Medicaid
Plans (MMPs), like MIHL, terminated on December 31, 2023, unless the program was converted to an “integrated”
Dual Eligible Special Needs Plan (D-SNP). To convert to the new program structure/model, Michigan submitted its
initial “transition plan” to CMS on September 30, 2022.
In February 2023, Michigan Department of Health and Human Services (MDHHS) leadership announced their plan
to:
- Facilitate a phased approach by first transitioning the MI Health Link program on January 1, 2026, and pursuing statewide expansion thereafter.
- Develop a new Managed Care program for the Highly Integrated Dual Eligible (HIDE) + Long Term Services & Supports (LTSS) Special Needs Plan (SNP) model that directly contracts with, and capitates, participating plans to allow for stronger quality oversight at the State level.
- Procure HIDE + LTSS SNPs by October 31, 2024, for a January 1, 2026, contract effective date.
- Limit coordination-only D-SNPs to regions that do not have procured HIDE + LTSS D-SNPs to promote integration.
- Require Exclusively Aligned Enrollment in the new HIDE + LTSS SNP model.
- Limit enrollment in the new HIDE + LTSS SNP to full benefit dual who are 21 years or older.
- Maintain the current MI Health Link benefit package to the extent possible through the contracting process, including 1915(c) Home and Community Based Services (HCBS).
- Develop and require integrated materials, including appeals and grievance materials, for new HIDE + LTSS SNP model.
- Develop a robust quality oversight program, similar to the existing MI Health Link program, that evaluates the HIDE + LTSS SNPs at the plan level rather than the parent organization level.
- Organize a Beneficiary Advisory Committee for the new HIDE + LTSS SNP model to inform program improvements and quality initiatives.
- Maintain an Ombudsman Program to support beneficiaries through the transition to the new model and with the new model moving forward.
- Continue to facilitate stakeholder engagement opportunities to gather input and inform the new program's constructs.
MDHHS conducted a procurement in October 2024 and announced in November 2024 the awardees, including the
counties applicable, located here: MDHHS issues updated award recommendations for nine health plans to
provide new MI Coordinated Health dual eligible benefit program.
Prosperity Regions 1, 8, and 10 will launch on January 1, 2026. Mid-State Health Network’s twenty-one counties
will be included in the program on January 1, 2027.
The resulting program is driven by five project pillars:
- Fostering integration and continuity
- Reducing racial disparities
- Improving care delivery
- Promoting self-determination
- Building a culture of quality
Visit the MDHHS website to learn more about the Highly Integrated Dual Eligible Special Needs Plan.
For further information or questions, please contact Amanda at Amanda.Ittner@midstatehealthnetwork.org