Michigan Announces Regional Managed Care Health Plans > Michigan State Medical Society

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Michigan Announces Regional Managed Care Health Plans

The Michigan Department of Health and Human Services (MDHHS) earlier this week an update to the recommended Medicaid Health Plans (MHPs) in Region 7 for Michigan’s Comprehensive Health Plan contract. The MHPs were initially announced on Tuesday based on approved scoring criteria. Since that time, MDHHS has identified and corrected scoring errors that change the award recommendations in Region 7 only.  

The rescored criteria involve points awarded for existing provider networks. The corrected scores result in the following health plan recommendations for Region 7: Blue Cross Complete of Michigan, McLaren Health Plan, Meridian Health Plan and United Healthcare Community Plan. All other award recommendations remain the same.

Michigan’s Comprehensive Health Plan contract provides health care services to approximately 1.7 million Medicaid managed care beneficiaries. The current Comprehensive Health Plan contract will end on December 31, 2015, and the new contracts announced will begin January 1, 2016. The Comprehensive Health Plan contract includes changes to the service area locations and requirements to align with Michigan’s Prosperity Regions, as well as a new Medicaid coverage group.

MDHHS issued a Request for Proposals in May 2015 after making changes and incorporating stakeholder input as a result of feedback and discussions during the budget process. The new contract will continue to carve-in pharmaceutical drugs, and will add a common formulary for all managed care entities by January 1, 2016. All bids were reviewed by a joint evaluation committee and the recommendations for contract award must now be approved by the State Administrative Board before contracts are final.

The updated recommended health plans by region are:

  • Region 1 – Upper Peninsula Health Plan
  • Region 2 – McLaren Health Plan, Meridian Health Plan of Michigan, Molina Healthcare of Michigan, UnitedHealthcare Community Plan
  • Region 3 – McLaren Health Plan, Meridian Health Plan of Michigan, Molina Healthcare of Michigan, UnitedHealthcare Community Plan
  • Region 4 – Blue Cross Complete of Michigan, McLaren Health Plan, Meridian Health Plan of Michigan, Molina Healthcare of Michigan, Priority Health Choice, UnitedHealthcare Community Plan
  • Region 5 – McLaren Health Plan, Meridian Health Plan of Michigan, Molina Healthcare of Michigan, UnitedHealthcare Community Plan
  • Region 6 – Blue Cross Complete of Michigan, HAP Midwest Health Plan, McLaren Health Plan, Meridian Health Plan of Michigan, Molina Healthcare of Michigan, UnitedHealthcare Community Plan
  • Region 7 – Blue Cross Complete of Michigan, McLaren Health Plan, Meridian Health Plan, UnitedHealthcare Community Plan
  • Region 8 – Aetna Better Health of Michigan, McLaren Health Plan, Meridian Health Plan of Michigan, Molina Healthcare of Michigan, Priority Health Choice, UnitedHealthcare Community Plan
  • Region 9 – Aetna Better Health of Michigan, Blue Cross Complete of Michigan, McLaren Health Plan, Meridian Health Plan of Michigan, Molina Healthcare of Michigan, UnitedHealthcare Community Plan
  • Region 10 – Aetna Better Health of Michigan, Blue Cross Complete of Michigan, Harbor Health Plan, McLaren Health Plan, Meridian Health Plan of Michigan, Molina Healthcare of Michigan, Total Health Care, UnitedHealthcare Community Plan

Additional information for beneficiaries, providers and other stakeholders will be made available as the January 1 implementation date approaches.

View a map of the recommended health plans listed by prosperity region >>

View the updated Medicaid Health Plans PR.pdf >>

Posted in: State Government News, Medicaid, Hot Topics, News for Practices, Insurance

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