HB 4726 Michigan House · 2025-2026 Regular Session

Health facilities: county medical care facilities; maintenance of effort reimbursement; extend sunset. Amends sec. 109 of 1939 PA 280 (MCL 400.109).

HB 4726 extends the deadline for a reimbursement formula that helps counties offset costs when operating Medicaid-funded nursing homes. It requires counties to be reimbursed for 45% of the difference between their actual per-patient-day costs and a state-set cost limit (with rates capped at zero if costs are below the limit), while preventing annual reimbursement increases exceeding $1.00 per patient day. This policy directly affects county-owned nursing homes providing Medicaid long-term care, ensuring continued state support for their operations until December 31, 2030. The bill does not change eligibility for services or create new benefits - only extends the existing funding mechanism.

Issues: ✓ Healthcare

Bill status signed all 5 stages cleared

Introduction

Jul 2025

Committee Review

Dec 2025

House Passage

Nov 2025

Senate Passage

Dec 2025

Signed into Law

Dec 2025

Introduced Jul 15, 2025 Signed Dec 31, 2025

Maddy AI version diff · 2 comparisons

What changed between versions

As Passed by the House → House Concurred Bill · 5 edits

MODERATE

This bill amends Michigan's social welfare act to expand medical services covered under the program, update reimbursement rules for county-owned nursing homes, and clarify definitions of federal benefit titles. The changes add new covered services like mental health screenings, opioid detoxification, and chronic kidney disease treatment, while also adjusting how counties are reimbursed for nursing home care.

Scope change

The bill expands the scope of covered medical services and modifies reimbursement mechanisms for county-owned facilities without changing who is eligible for benefits.

REQUIREMENT

Added new covered services including mental health screenings during postpartum, opioid detoxification, inpatient care for substance use disorders, and chronic kidney disease treatment with specific reporting requirements.

Added requirement for the director to obtain legislative committee approval for proposed reimbursement changes that would alter payments by 1% or more.

FISCAL

Modified nursing home reimbursement rules for county-owned facilities with detailed calculations for maintenance of effort rates based on variable costs and facility types.

TIMELINE

Extended a reimbursement limitation date from December 31, 2025 to December 31, 2030 for county maintenance of effort rates.

DEFINITION

Added definitions for federal benefit titles XVIII, XIX, and XX to clarify which federal programs are referenced in the act.

Floor votes · Senate Dec 18, 2025 · House Nov 6, 2025

How they voted

36–0

Passed · 2 other

Total votes 38

Dec 18, 2025

D Democratic19

17 Yea 2

89% Yea

R Republican19

19 Yea

100% Yea

Vote distribution

All Yea All Nay Mixed No data

Full legislative history

Actions timeline

Total actions

Key actions

Committee

Amendments

Dec 31, 2025

Introduced

filed with Secretary of State 12/23/2025 11:42 AM

lower

Dec 31, 2025

Signed into law

approved by the Governor 12/23/2025 10:12 AM

lower

Dec 18, 2025

Introduced

returned from Senate without amendment with immediate effect and full title

lower

Dec 18, 2025

Upper · Passed

PASSED; GIVEN IMMEDIATE EFFECT ROLL CALL # 361 YEAS 35 NAYS 0 EXCUSED 2 NOT VOTING 0

upper

Dec 18, 2025

Upper · Passed

REPORTED BY COMMITTEE OF THE WHOLE FAVORABLY WITHOUT AMENDMENT(S)

upper

Dec 18, 2025

Upper · Passed

DISCHARGE COMMITTEE APPROVED

upper

Nov 12, 2025

Committee

REFERRED TO COMMITTEE ON HEALTH POLICY

upper

Nov 12, 2025

Upper · Passed

PASSED BY HOUSE WITH IMMEDIATE EFFECT

upper

Nov 6, 2025

Lower · Passed

passed; given immediate effect Roll Call #294 Yeas 97 Nays 3 Excused 0 Not Voting 10

lower

Oct 29, 2025

Committee

referred to second reading

lower

Oct 29, 2025

Lower · Passed

reported with recommendation without amendment

lower

Jul 15, 2025

Committee

referred to Committee on Insurance

lower

Jul 15, 2025

Introduced

introduced by Representative Rep. Matthew Bierlein

lower

1 primary · 3 co-sponsors