MMP 26-22 - Updates to the MDHHS Medicaid Provider Manual (July 2026 Updates)

What this rule requires your agency to do

• 1A New Agency Provider Compliance Review requires submission of three months of payroll records including agency caregiver names, pay period dates, payment amounts, FICA withholdings, and proof of compliance with state unemployment insurance filings and payments; if payroll records do not verify tax payments the provider may need to submit Form UIA 1028 and IRS Form 941 (Home Help 8.5.B).(MMP 26-22 - Updates to the MDHHS Medicaid Provider Manual (July 2026 Updates))
• 2A client requesting an increase in Home Help services must participate in a new review and comprehensive assessment update with the ASW before the increase can be authorized; if the client is non-verbal or requests an in-person visit, the review and assessment must be conducted in person in the client's home (Home Help 5.3.C).(MMP 26-22 - Updates to the MDHHS Medicaid Provider Manual (July 2026 Updates))
• 3Programs requiring EVV for HHCS or PCS must comply with the EVV chapter; failure may result in non-payment of Medicaid services, and providers must follow EVV reporting requirements (EVV Section 5).(MMP 26-22 - Updates to the MDHHS Medicaid Provider Manual (July 2026 Updates))
• 4All agency caregivers who provide Home Help services must successfully complete CHAMPS revalidation and be actively enrolled in CHAMPS at the time they provide Home Help services, and the agency owner is responsible for monitoring revalidation status (Home Help 8.4.B.1).(MMP 26-22 - Updates to the MDHHS Medicaid Provider Manual (July 2026 Updates))
• 5The client's medical need for Home Help services must be certified on Form MDHHS-6200 or DHS-54A (or VA Form 10-10M) completed by a Medicaid provider enrolled in CHAMPS holding a listed professional license (MD/DO, physician assistant, nurse practitioner, occupational therapist, or physical therapist), who must enter their NPI and indicate Medicaid-enrollment status (Home Help 5.2).(MMP 26-22 - Updates to the MDHHS Medicaid Provider Manual (July 2026 Updates))
• 6All nurses providing Private Duty Nursing to waiver enrollees must maintain a current State of Michigan nursing license per MCL 333.17201-17242; PDN must be ordered by a physician, physician's assistant, clinical nurse specialist, or nurse practitioner, and the direct-service PDN provider must send case notes to the HIDE SNP care coordinator no less than quarterly (MI Coordinated Health 1.2.B.13).(MMP 26-22 - Updates to the MDHHS Medicaid Provider Manual (July 2026 Updates))
• 7Agency providers, including FMS providers, must achieve a quarterly threshold of 85 percent of EVV records for verified visits without manual edits, calculated per individual payer; providers below the threshold are subject to corrective action such as retraining, mandatory training, submission of a compliance plan, and formal meetings (EVV 5.1).(MMP 26-22 - Updates to the MDHHS Medicaid Provider Manual (July 2026 Updates))
• 8MI Choice waiver agencies must track and respond to critical incidents using the Critical Incident Reporting web-based system and must notify MDHHS of suspicious deaths within two business days (MI Choice Waiver 10.4.C).(MMP 26-22 - Updates to the MDHHS Medicaid Provider Manual (July 2026 Updates))