Page 9

BAM 210 9 of 25 REDETERMINATION/EX PARTE REVIEW BPB 2026-016 7-1-2026

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

• DHS-4574, Medicaid Application (Patient of Nursing Facility). The packet includes the following as determined by the TOA to be redetermined: • Redetermination/review/renewal form indicated above. • Notice of review as determined by policy. • Interview date. • Interview type. • Place and time. • Required verifications. • Due date. • Return envelope. FAP Only If the MDHHS-1171, and the MDHHS-1171-FAP must be manually sent, mail them no later than two workdays before the first day of the redetermination month. If the forms are not mailed within that time, adjust the timely filing date; see FAP Timely and Untimely Filing Date in this item. Clients may be, but are not required to be, interviewed before the timely filing date. CDC Only At redetermination if the CDC asset question is not addressed, the client will need to be contacted to certify the program group's assets do not exceed $1 million. Early Redetermination FIP, SDA, RCA, MA and FAP Redetermination of an active program may be scheduled up to three months before the review date. Redetermination of active programs may be necessary for one of the following reasons: • Case is found to be error prone as a result of supervisory case reading, quality assurance data or quality enhancement data. • Specialist’s schedule requires early redetermination of active program.

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Page 9

Official source

BAM 210 9 of 25 REDETERMINATION/EX PARTE REVIEW BPB 2026-016 7-1-2026

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

• DHS-4574, Medicaid Application (Patient of Nursing Facility). The packet includes the following as determined by the TOA to be redetermined: • Redetermination/review/renewal form indicated above. • Notice of review as determined by policy. • Interview date. • Interview type. • Place and time. • Required verifications. • Due date. • Return envelope. FAP Only If the MDHHS-1171, and the MDHHS-1171-FAP must be manually sent, mail them no later than two workdays before the first day of the redetermination month. If the forms are not mailed within that time, adjust the timely filing date; see FAP Timely and Untimely Filing Date in this item. Clients may be, but are not required to be, interviewed before the timely filing date. CDC Only At redetermination if the CDC asset question is not addressed, the client will need to be contacted to certify the program group's assets do not exceed $1 million. Early Redetermination FIP, SDA, RCA, MA and FAP Redetermination of an active program may be scheduled up to three months before the review date. Redetermination of active programs may be necessary for one of the following reasons: • Case is found to be error prone as a result of supervisory case reading, quality assurance data or quality enhancement data. • Specialist’s schedule requires early redetermination of active program.