RWC Advocacy

1 day ago

Public Comment on MDHHS Medicaid Health Plan Common Formulary

The Michigan Department of Health and Human Services (MDHHS) is soliciting comments from the public on the Michigan Medicaid Health Plan Common Formulary. The Common Formulary applies to pharmacy claims paid by Medicaid Managed Care Organizations – it will not apply to claims paid through Fee-for-Service. The public may submit comments on the drugs included or not included on the Common Formulary, new drug products, prior authorization criteria, step therapy criteria and other topics related to drug coverage under the Common Formulary.

The comments will be reviewed by MDHHS and the Michigan Medicaid Health Plan Common Formulary Workgroup. The next drug classes to be reviewed by the Workgroup include Analgesics, CNS, Dermatological and Anti-Neoplastic. Changes may be made to the Common Formulary based on comments received. Comments will be solicited once per calendar quarter.

The Michigan Medicaid Health Plan Common Formulary can be found at www.michigan.gov/mcopharmacy.

Please send your comments by November 23, 2018 to:

Linda VanCamp, Formulary Analyst
Bureau of Medicaid Care Management & Quality Assurance
Medical Services Administration
P.O. Box 30479
Lansing, Michigan 48909-7979

Telephone Number: 517-373-9252
Fax Number: 517-763-0142
E-mail Address:

MDHHSCommonFormulary@michigan.gov ... See MoreSee Less

RWC Advocacy

1 month ago

Press Release
________________________________________
FOR IMMEDIATE RELEASE: Sept. 14, 2018
CONTACT: Lynn Sutfin, 517-241-2112, SutfinL1@michigan.gov

MDHHS to seek contract with existing Prepaid Inpatient
Health Plan for Section 298 Initiative

LANSING, Mich. – The Michigan Department of Health and Human Services (MDHHS) announced today that it will contract with one of Michigan’s existing Prepaid Inpatient Health Plans (PIHP) as part of the Section 298 Initiative. The selected PIHP will be responsible for managing the specialty behavioral health benefits for individuals who are not enrolled in a Medicaid Health Plan within the pilot regions.

The Section 298 Initiative is a statewide effort to improve the coordination of physical health services and behavioral health services in Michigan. This initiative is based upon Section 298 in Public Act 268 of 2016. The Michigan legislature approved a revised version of Section 298 as part of Public Act 207 of 2018.

Under Section 298, the legislature directed MDHHS to implement up to three pilots to test the integration of Medicaid-funded physical health and behavioral health services. As part of the pilots, MDHHS will contract with the Medicaid Health Plans (MHP) within the pilot regions for the management of Medicaid-funded physical health and behavioral health services. The MHPs will contract with the Community Mental Health Service Programs (CMHSP) within the pilot sites for the delivery of specialty behavioral health services and supports. The three pilot sites are:

• HealthWest and West Michigan Community Mental Health

• Genesee Health System

• Saginaw County Community Mental Health Authority

Approximately 25 percent of the Medicaid population is not enrolled in an MHP for management of their physical health services; therefore, MDHHS is not able to enroll these
individuals in the MHPs for the pilots. Instead, MDHHS will issue a Request for Proposals (RFP) to select a single existing PIHP to manage the specialty behavioral health benefit for the unenrolled population. The selected PIHP will also contract with the CMHSPs for the delivery of specialty behavioral health services and supports.

MDHHS expects to issue the RFP no later than January 2019. MDHHS will work with the selected PIHP, CMHSPs and MHPs in the pilot sites to implement the pilots by Oct.1, 2019. For more information about the Section 298 Initiative, visit Michigan.gov/stakeholder298.

• Section+298+Update+PR.pdf ... See MoreSee Less