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BAM 120 5 of 12 MSA/MDHHS COORDINATION BPB 2026-007 4-1-2026

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

Integrated Care Organizations (ICO)/Provider ID Aetna Better Health of MI 2836392 2836393 Fidelis SecureCare of MI 2836406 2836407 HAP Midwest Health Plan 2836404 2836405 Meridian Health Plan 2836394 2836396 Molina HealthCare 2836399 2836400 UP Health Plan 2836390 2836403 When a beneficiary enters LTC, the provider will enter the information into CHAMPS in order to change the PET code. MDHHS LOCAL OFFICE RESPONSIBILITY • Computing the patient-pay amount (PPA). When a nursing facility notifies MDHHS that a beneficiary has been discharged from the LTC facility, complete the following steps: • Update PPA. When a nursing facility notifies MDHHS that a beneficiary has changed facilities complete the following step:

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Official source

BAM 120 5 of 12 MSA/MDHHS COORDINATION BPB 2026-007 4-1-2026

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

Integrated Care Organizations (ICO)/Provider ID Aetna Better Health of MI 2836392 2836393 Fidelis SecureCare of MI 2836406 2836407 HAP Midwest Health Plan 2836404 2836405 Meridian Health Plan 2836394 2836396 Molina HealthCare 2836399 2836400 UP Health Plan 2836390 2836403 When a beneficiary enters LTC, the provider will enter the information into CHAMPS in order to change the PET code. MDHHS LOCAL OFFICE RESPONSIBILITY • Computing the patient-pay amount (PPA). When a nursing facility notifies MDHHS that a beneficiary has been discharged from the LTC facility, complete the following steps: • Update PPA. When a nursing facility notifies MDHHS that a beneficiary has changed facilities complete the following step: