The Michigan State Medical Society (MSMS) Health Care Delivery Department receives news from several of Michigan’s health plans and insurers related to policies, programs, and education opportunities. Below are some updates which may be of interest to physicians and other health care team members.
CMS News
CMS Launches Medicare GLP-1 Bridge, Expanding Access to GLP-1 Medications
The Centers for Medicare & Medicaid Services (CMS) launched the Medicare GLP-1 Bridge, a new initiative that allows eligible Medicare Part D beneficiaries to access certain GLP-1 medications for weight loss or weight maintenance at a predictable cost of $50 per month. The initiative will remain available through December 31, 2027, and is designed to expand access to innovative treatments while testing the impact of broader GLP-1 access on the Medicare program. For more information about the program, visit http://medicare.gov/glp1bridge.
New Webinars
The following webinars are open for registration. Visit the Live Events webpage to learn more and register.
Direct Data Entry – Claim Entry
August 11, 2026, 11:00 am – 12:00 pm
Learn how DDE can assist Part A Providers with billing and claim processing. Topics include:
- Locating the Claims/Attachments Menu
- Reviewing the process for entering claims
Journey to Medicare Success
August 13, 2026, 11:00 am – 12:00 pm
This session is designed to help new providers and credentialing staff get started with Medicare. During this session you will be provided with the basics you need, including:
- Tips for maintaining your enrollment record
- Tools and resources
- Educational opportunities
- Contact information
McLaren Health Plan News
McLaren Health Plan has updated its Medicaid Provider Manual to extend the time providers have to submit and correct claims. Effective immediately, providers have one year (365 days) from the date of service or discharge, or 90 days from an MHP administrative action (whichever is later), to submit initial, corrected, or replacement Medicaid claims.
Claims that receive front-end rejections are not considered submitted and must be corrected and successfully resubmitted within the same one-year filing window. Coordination of Benefits (COB) requirements remain unchanged, with COB claims due within 12 months of the date of service or 90 days from the primary payer's EOP, whichever applies.
Providers should continue to use the Provider Claim Adjustment Form or contact McLaren Health Plan Customer Service to request claim adjustments. Electronic submission of claim adjustment requests is not available. For further details, please refer to the updated McLaren Health Plan Provider Manual. If you have questions regarding specific claims, please contact MHP Customer Service at (888) 327-0671 or your Provider Relations Representative.
HAP News
Reminder: Payment Changes for Specific Behavioral Health Provider Types
Effective December 1, 2025, in alignment with the Centers for Medicare & Medicaid Services, payment will be 75 percent of the allowed amount for the following behavioral health specialties:
- Clinical Social Worker
- Marriage & Family Therapist
- Mental Health Counselor
This affects all HAP Commercial and HAP Medicare Advantage business
BCBSM/BCN News
New FAQ on Electronic Medical Record Connectivity is Now Available
Blue Cross and Blue Care Network is now able to automatically exchange data with providers through select electronic medical record, or EMR, systems. To help you understand this change, BCBSM has published a new Electronic Medical Record connectivity: FAQs for providers document. Read more: July 2026 issue of The Record.
Radiation oncology and radiopharmaceutical procedure codes to be managed through the Oncology Value Management Program
Radiation oncology services and radiopharmaceuticals will be managed through the Oncology Value Management program, administered by OncoHealth, for dates of service on or after September 1, 2026. Read more: July 2026 issue of The Record
For further questions or assistance, contact Dara Barrera, Director, Health Quality, Equity and Technology at djbarrera@msms.org.