Revised Reporting Requirements for Medicare-Medicaid Plans in Michigan Announced
Relevant to: State Medicare-Medicaid Plan Handbooks, Audit Protocol
Each week, we scan the latest CMS memos to find the most important ones that apply for PACE programs. Below is a summary of what you need to know.
Disclaimer: The content provided on this site is a summary for informational purposes only, and Grane PBM, Inc. assumes no liability for any errors or omissions in the site’s content. The information does not constitute legal or regulatory advice or replace the original CMS memo. Readers are advised to consult the CMS memo in its entirety and to verify information independently before making any decisions based on this information.
Click here to read the complete memo from CMS.
Introduction
The Department of Health & Human Services has issued a memorandum concerning the updated Medicare-Medicaid Capitated Financial Alignment Model Reporting Requirements specific to Michigan. This revision introduces changes in technical specifications and value sets that Michigan Medicare-Medicaid Plans must integrate and utilize by mid-2025. The modifications focus on enhancing clarity and efficiency in reporting processes for measures MI2.6 and MI5.6, ensuring all submissions meet the updated standards for improved healthcare coordination efforts.
Key Dates and Deadlines
CONTENT TO USE FOR GENERATION: The content includes a memorandum with key dates related to the Michigan Medicare-Medicaid Plans reporting requirements. Important dates mentioned include:
DATE of the memorandum: February 28, 2025,
Due date for measures with updated specifications and value sets: on or after June 2, 2025,
Reference date for the Prevention Quality Indicators technical specifications for reporting measure MI5.1: April 30, 2025.
PACE Compliance
The memo is relevant to PACE programs because it outlines specific reporting requirements and updates for Medicare-Medicaid Plans (MMPs) in Michigan, which may also apply to PACE organizations operating within the state under similar frameworks. PACE organizations, although not directly addressed in this memo, should be aware of these changes as they might indicate broader trends or forthcoming updates that could affect their compliance obligations.
Plans must incorporate the revised Michigan-Specific Reporting Requirements and the updated Michigan-Specific Value Sets Workbook by June 2, 2025, to ensure compliance. These changes include critical updates to measures such as MI2.5 and MI5.6, which PACE organizations might have analogous reporting parallels they need to adhere to.
Additionally, for reporting measure MI5.1, plans need to use the latest Prevention Quality Indicators technical specifications by April 30, 2025. While PACE programs might have different quality measures to report, staying informed about these changes is crucial as similar requirements could be introduced in their reporting guidelines.
In summary, organizations must remain vigilant and adjust their compliance frameworks accordingly to accommodate these updates. Failing to adhere to the updated requirements could potentially lead to issues in compliance audits or other oversight mechanisms.
Required Actions
The memorandum from the Medicare-Medicaid Coordination Office outlines changes and requirements that Medicare-Medicaid Plans (MMPs) in Michigan need to adhere to regarding reporting requirements and value sets. Here are the required actions:
- Review the revised Michigan-Specific Reporting Requirements and the corresponding Michigan-Specific Value Sets Workbook to stay informed about the updates in technical specifications and applicable codes.
- Incorporate the updated value sets, especially for measures MI2.5 and MI5.6, into your reporting processes for measures due on or after June 2, 2025.
- Reference the latest Prevention Quality Indicators technical specifications for reporting measure MI5.1 by the deadline of April 30, 2025.
FAQs
- “What are the revised Michigan-Specific Reporting Requirements?”
- “When will Michigan MMPs need to use the updated specifications and value sets?”
- “What changes were made to the reporting requirements for Measure MI2.6?”
- “How have specifications for Measure MI5.6 been updated?”
