MI Issues Recommendations on Health Plans – Nov. 13

Lansing, MichiganNovember 17, 2015 – The Michigan Department of Health and Human Services today announced the final recommendations for the Medicaid Health Plans (MHPs). The recommendations are a result of the Department of Technology, Management and Budget’s independent review process.

The first round of updates to the recommended MHPs was announced on October 15 based on approved scoring criteria. During the allotted protest period, MDHHS and DTMB received protests, after which the DTMB initiated a protest review process. The Joint Evaluation Committee was reconvened to reevaluate scoring and submissions. Below are recommendations that will be forwarded to the State Administrative Board for approval.

Michigan’s Comprehensive Health Plan contract provides health care services to approximately 1.7 million Medicaid managed care beneficiaries. The current Comprehensive Health Plan contract will end on December 31, 2015, and the new contracts announced will begin January 1, 2016. The Comprehensive Health Plan contract includes changes to the service area locations and requirements to align with Michigan’s Prosperity Regions, as well as a new Medicaid coverage group.

MDHHS issued a Request for Proposal in May 2015 after making changes and incorporating stakeholder input as a result of feedback and discussions during the budget process. The new contract will continue to carve-in pharmaceutical drugs, and will add a common formulary for all managed care entities by January 1, 2016. All bids were reviewed by a joint evaluation committee and the recommendations for contract award must now be approved by the State Administrative Board before contracts are final.

The final updated recommended health plans by region are:

  • Region 1 – Upper Peninsula Health Plan
  • Region 2 – McLaren Health Plan, Meridian Health Plan of Michigan, Molina Healthcare of Michigan, UnitedHealthcare Community Plan
  • Region 3 – McLaren Health Plan, Meridian Health Plan of Michigan, Molina Healthcare of Michigan, UnitedHealthcare Community Plan
  • Region 4 – Blue Cross Complete of Michigan, McLaren Health Plan, Meridian Health Plan of Michigan, Molina Healthcare of Michigan, Priority Health Choice, UnitedHealthcare Community Plan
  • Region 5 – McLaren Health Plan, Meridian Health Plan of Michigan, Molina Healthcare of Michigan, UnitedHealthcare Community Plan
  • Region 6 – Blue Cross Complete of Michigan, HAP Midwest Health Plan, McLaren Health Plan, Meridian Health Plan of Michigan, Molina Healthcare of Michigan, UnitedHealthcare Community Plan
  • Region 7 – Blue Cross Complete of Michigan, McLaren Health Plan, Meridian Health Plan, Molina Healthcare of Michigan
  • Region 8 – Aetna Better Health of Michigan, McLaren Health Plan, Meridian Health Plan of Michigan, Molina Healthcare of Michigan, Priority Health Choice, UnitedHealthcare Community Plan
  • Region 9 – Aetna Better Health of Michigan, Blue Cross Complete of Michigan, McLaren Health Plan, Meridian Health Plan of Michigan, Molina Healthcare of Michigan, UnitedHealthcare Community Plan
  • Region 10 – Aetna Better Health of Michigan, Blue Cross Complete of Michigan, Harbor Health Plan, McLaren Health Plan, Meridian Health Plan of Michigan, Molina Healthcare of Michigan, Total Health Care, UnitedHealthcare Community Plan

Additional information for beneficiaries, providers and other stakeholders will be made available as the January 1 implementation date approaches.


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