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

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

MI Health Link Member Becomes L/H Client Beneficiaries enrolled in MI Health Link, a program for individuals dually enrolled in Medicare and Medicaid, are eligible to remain enrolled in MI Health Link when they enter a long term care (LTC) facility. Individuals in MI Health Link are enrolled in a health plan known as an Integrated Care Organization (ICO), which provides all Medicare and Medicaid services, including long term care services to individuals. Since MI Health Link allows beneficiaries to remain enrolled in an ICO, the LTC facility does not contact the ICO to request that the individual be disenrolled from the ICO. Additionally, the ICO will not submit a request for disenrollment to MDHHS/MSA. Instead the LTC facility will inform the ICO when a member is admitted so that the facility and ICO can coordinate the individual's care. MDHHS is able to identify if an individual is enrolled in an ICO by checking the provider ID associated with the PET code. MI Health Link uses eight PET codes. • ICO-HCBS: Individual meets nursing facility level of care determination (LOCD) and lives in the community. Lives in the home and receives community based waiver services. • ICO-NFAC: Resident of nursing facility. • ICO-COMM, ICO-HOSH, ICO-HOSR, ICO-HOSN, ICO-HOSW : Enrolled in Medicaid managed care. • ICO-CMCF: Resident of a county medical care facility (CMCF). Each PET code will accompany a provider ID number. Each ICO has two provider IDs. One number identifies if the individual voluntarily enrolled in the ICO, and one number those individuals automatically enrolled in the ICO. The first number listed indicates voluntarily enrolled, the second indicates automatic or passively enrolled.