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Tuesday, April 29, 2014

PIHPs to receive $26.9 million in Health Michigan payments today (4.30)

The Michigan Department of Community Health Tuesday notified Prepaid Inpatient Health Plans they will be receiving an electronic funds transfer payment on Wednesday, April 30, for new Healthy Michigan members who have enrolled in the first three weeks of April. 
"We are pleased to announce this payment brings the total state General Fund and Healthy Michigan payments in April to PIHPs and Community Mental Health Authorities to a statewide total of $26.9 million and exceeds the March state General Fund and Adult Benefits Waiver payment total of $26.6 million," the MDCH said in a statement.
The payment is a full retro-eligibility payment and covers the newly eligible Healthy Michigan members enrolled after the Adult Benefits Waiver auto-enrollments for the full month of April, the MDCH said. The payment ensures maximum April capitation is received for the month in which members enroll.  The remaining April members enrolled in the final week of April will also be reimbursed for the entire month of April and will be paid in mid-May, the department said.  

The first retro payment represents the number of persons who enrolled in Healthy Michigan during the first three weeks of April in each region and is being transmitted in advance of final April enrollment to help alleviate concerns with cash flow during this time of transition. 
"We will continue to monitor enrollment and assess the need for retroactive payments on a monthly basis through the fiscal year ending Sept. 30, 2014," the statement said.
The additional payment is an estimate and will need to be reconciled with eligibility and payment files in the future, according to the MDCH. 

It is expected that PIHPs will expedite cash flow related to these retro payments consistent with regional and CMH agreements regarding regular payments.  

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