Michigan House Bill 6274 establishes a state basic health program to provide medical coverage for low-income residents who do not qualify for Medicaid or affordable employer-sponsored insurance. The bill targets individuals aged 65 and under with incomes between 133% and 200% of the federal poverty guidelines, as well as lawfully present noncitizens earning below 200% of that threshold. It creates a dedicated trust fund to finance the program and requires the state department to develop a program blueprint for federal certification within six months of forming a stakeholder advisory group. Key provisions include automatic enrollment for individuals transitioning from Medicaid, sliding-scale premiums based on income, and a requirement that no one earning below 133% of the poverty line pay any premiums or cost-sharing.
Michigan House Bill 6288 directs the state Department of Health and Human Services to seek federal approval for enrolling specific Medicaid-eligible individuals into managed care plans, while requiring these plans to spend at least 12% of their annual budget on primary care over an eight-year period. The bill mandates that hospitals accept Medicare rates as full payment from uninsured patients with incomes up to 250% of the federal poverty level and establishes a performance bonus system for health plans based on quality metrics such as fraud detection, substance use disorder treatment, and consumer satisfaction. Additionally, it requires contracted health plans to submit annual reports detailing their primary care spending levels and outlines provisions for telemedicine access, pharmaceutical cost controls, and the sharing of state data with qualified vendors to improve population health management.
This bill directs the Michigan Department of Health and Human Services to expand managed care options for Medicaid recipients, giving them a choice among contracted health plans while ensuring access to primary care and preventive services. It requires new enrollees to schedule an initial appointment with a primary care provider within 60 days and mandates that the department track plan compliance with this requirement. The legislation also establishes financial incentives for providers and enrollees to encourage the use of high-value services, promote generic prescriptions, and detect fraud, while allowing telemedicine from out-of-state providers. Additionally, the bill outlines a performance bonus system for health plans based on specific health equity and outcome targets, and sets rules for automatically moving individuals out of skilled nursing facilities after 45 days of care.
This bill updates Michigan's Medicaid False Claim Act to clarify what counts as a kickback or bribe. It maintains that offering, soliciting, or accepting payments to refer patients for medical services is a felony punishable by up to four years in prison or a fine of $30,000. The law explicitly excludes government-approved "model arrangements" and "model patient incentives" from being considered illegal kickbacks. This change aims to provide clearer guidance on which financial incentives are permissible under federal and state programs.
This bill updates Michigan's Medicaid False Claims Act to clarify what counts as an illegal kickback or bribe in the medical services sector. It maintains the existing rule that offering or receiving payments to refer patients for services is a felony punishable by up to four years in prison or a fine of $30,000. The legislation adds a specific exemption stating that "model arrangements" and "model patient incentives" approved by the Centers for Medicare and Medicaid Services are not considered illegal kickbacks. This change aims to provide legal clarity for healthcare providers participating in federal-approved incentive programs while preserving penalties for other forms of improper referral payments.
This bill proposes to allow Michigan residents to receive medical assistance coverage retroactively for up to one month before they apply, with an extension to two months for those eligible under the non-expansion Medicaid population. The changes would take effect on January 1, 2027, and apply to individuals who meet specific citizenship and eligibility requirements defined in the state's social welfare act. By modifying the Social Welfare Act, the legislation aims to provide a grace period for applicants to access healthcare services while their applications are being processed.
This bill amends Michigan's ABLE program to allow individuals with disabilities to designate a specific survivor beneficiary for their savings accounts. It also exempts these accounts from Medicaid estate recovery, ensuring that funds remain protected for the individual's qualified disability expenses even after their death. The legislation clarifies the roles of account owners and designated representatives, permitting changes to beneficiaries within the family unit without requiring court approval. By updating the state's ABLE program rules, the bill aims to provide greater flexibility and financial security for people with disabilities and their families.
This bill directs the Michigan Department of Community Health to establish a Medicaid estate recovery program that seeks repayment from the estates of deceased recipients for certain medical services. A key provision prohibits the state from filing claims against funds held in an ABLE savings account, protecting these assets from recovery efforts. The legislation also outlines specific exemptions, such as protecting the homes of surviving spouses, young children, disabled dependents, and certain caretaker relatives. Additionally, the bill requires the department to obtain federal approval before implementing the program and mandates that no interest be charged on recovered amounts.
This bill proposes to increase the mandatory minimum prison sentence for individuals convicted of conspiring to defraud the state of Michigan by submitting false Medicaid claims. Under the current law, such offenses are felonies punishable by up to 10 years in prison or a fine of up to $50,000, but this legislation would require a minimum sentence of 2 years and 6 months for anyone found guilty. The change directly affects healthcare providers, billing companies, and other entities or individuals involved in submitting false claims for Medicaid reimbursement. If passed, the amendment would take effect 90 days after it is signed into law.
This bill modifies Michigan's Social Welfare Act to clarify that certain substance use disorder programs exempt from licensure are eligible to provide medically necessary acute detoxification and inpatient care for opioid use disorder. The change updates section 109 of the Social Welfare Act to explicitly include these exempt programs alongside licensed facilities in the list of approved providers for substance use disorder treatment services. The amendment does not alter existing requirements for licensed facilities but ensures that unlicensed programs meeting specific criteria can access Medicaid funding for these services. The bill is tied with HB 5729 and was introduced in March 2026 by Representative Mike Harris.
