1) State: Michigan
2) Own or Federal Exchange? Federal Exchange through a partnership model. The Federally Facilitated
Marketplace will make assessments of Medicaid/CHIP eligibility and then transfer the applicant's
account to the Michigan state agency for a final eligibility determination.
Source: http://www.medicaid.gov/Medicaid-CHIP-Program-Information/By-State/michigan.html
3) Medicaid Expansion? Yes
Source: http://www.medicaid.gov/Medicaid-CHIP-Program-Information/By-State/michigan.html
4) What kind of coverage is available for mental health/substance abuse treatment through
Medicaid?
 Medical necessary services for substance abuse include:
Access Assessment and Referral Services
Outpatient Treatment
Intensive Outpatient Treatment
Methadone as an adjunct to therapy
Sub-Acute Detoxification
Residential Treatment
 Medically necessary services for mental health include:
Assertive Community Treatment Program (ACT)
Psychiatric Evaluation
Psychological Testing
Behavior Management Review
Child Therapy
Clubhouse Psychosocial Rehabilitation Programs
Crisis Interventions
Crisis Residential Services
Family Therapy
Home-based Services
Individual/Group Therapy
In-patient Psychiatric Hospitalization
Intensive Crisis Stabilization Services
Intermediate Care Facility for Individuals with
Mental Retardation (ICF/MR)
Medication Administration
Medication Review
Nursing Facility Mental Health Monitoring
Occupational Therapy
Outpatient Partial Hospitalization Services
Personal Care in Licensed Specialized Residential Settings
Physical Therapy, Speech, Hearing & Language
Targeted Case Management
Transportation
Treatment Planning
Assistive Technology
Community Living Supports
Enhanced Pharmacy
Environmental Modifications
Family Support & Training
Fiscal Intermediary Services
Housing Assistance
Peer-Delivered or Peer-Operated Support Services
Peer Support Specialist
Prevention-Direct Service Models
Respite Care Services
Skill Building Assistance
Support & Service Coordination
Supported/Integrated Employment Services
Wrap-Around
Source:
http://www.michigan.gov/documents/mdch/Medicaid_Specialty_Services_Waiver_194205_7.pdf
5) Does the state allow the court to order treatment and still have it paid by Medicaid?

The court can order treatment and have it paid by Medicaid if the services are covered by
Medicaid (shown in the question above).
6) Are there restrictions related to treatment providers for probationers, substance abuse, or mental
health treatment? Will only certain providers be covered?


The Michigan Department of Community Health (MDCH) oversees mental health treatment in
the state. The Behavioral Health and Developmental Disabilities Administration is located within
the MDCH. The administration carries out responsibilities specified in the Michigan Mental
Health Code, the Michigan Public Health Code and administers Medicaid Waivers for people
with developmental disabilities, mental illness, serious emotional disturbance and substance
disorders. Mental Health and Developmental Disability services in Michigan are delivered
through a county-based community mental health services programs.
Treatment providers must be contracted with MDCH and must have the appropriate license and
certification to treat patients in Michigan.
Source: http://www.michigan.gov/mdch/0,1607,7-132-2941---,00.html
7) Is there coverage for residential substance abuse treatment? What are the parameters?

Michigan has limited services available for Medicaid beneficiaries. All inpatient admissions must
be pre-approved by the Medicaid agency and all services must be prescribed by a physician. (See
question 4.)
Source:
http://www.michigan.gov/documents/mdch/Medicaid_Specialty_Services_Waiver_194205_7.pdf
http://store.samhsa.gov/shin/content/NMH05-0202/NMH05-0202-MI.pdf
8) What is the process and what are the regulations for treatment providers to be able to participate?


Providers must be licensed or certified to practice in the state of Michigan. They also must be
Michigan Medicaid Certified to receive reimbursements.
Medicaid reimbursement is available for mental and behavioral health services covered under
various service categories: physician services, inpatient and outpatient hospital services,
licensed practitioner’s services, clinics, and rehabilitative services.
Source: http://www.medicaid.gov/Medicaid-CHIP-Program-Information/By-Topics/Benefits/MentalHealth-Services-.html
9) Is dental care covered?


Dental care is an option in the Marketplace, but is not included in the basic plan (except for
children).
Michigan Medicaid adult dental care coverage is limited to an exam and cleaning two times per
year.
Source: http://kff.org/medicaid/state-indicator/dental-services/#