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BAM 120 12 of 12 MSA/MDHHS COORDINATION BPB 2026-007 4-1-2026

BRIDGES ADMINISTRATIVE MANUAL STATE OF MICHIGAN DEPARTMENT OF HEALTH & HUMAN SERVICES

• The transfer of assets was not disclosed as part of the Medicaid eligibility determination process, but the department determines that if it had been disclosed the applicant would still have been determined to be Medicaid eligible. • The transfer was disclosed as part of the Medicaid eligibly determination process, and a divestment penalty was assessed, which at the time of the decedent’s death was exhausted. MSA will refer a divestment to the Michigan Department of Health and Human Services Office of Inspector General, or MSA will seek additional recovery from the estate when either of the following are true: • The transfer of assets was disclosed as part of the Medicaid eligibility determination process, a divestment penalty period was assessed and the assessed penalty period had not been exhausted at the time of the beneficiary’s death. MSA will only seek the value of the outstanding penalty period that was assessed under these circumstances. • The transfer of assets was not disclosed as part of the Medicaid eligibility determination process, and the department determines that if it had been disclosed the applicant would not have been determined to be Medicaid eligible.

Cost-Sharing Limits The limit is based on income and applies to most types of health care coverage cost-sharing including HMP. Beneficiaries in the same household cannot be charged more than 5 percent of the family's income each calendar quarter for cost- sharing. Updates to the cost-sharing limit occur prospectively as income and other changes are received. MDHHS monitors the cost-sharing limit and costs as they are incurred and processes changes each quarter. Beneficiaries are not required to keep track of these costs.