HOUSE BILL NO. 5408

A bill to amend 1939 PA 280, entitled

"The social welfare act,"

by amending section 109f (MCL 400.109f), as amended by 2017 PA 224.

the people of the state of michigan enact:

Sec. 109f. (1) The department shall support the use of Medicaid funds for specialty services and supports for eligible Medicaid beneficiaries with a serious mental illness, developmental disability, serious emotional disturbance, or substance use disorder. Medicaid-covered specialty services and supports shall be managed and delivered by specialty prepaid health plans chosen by the department. The specialty services and supports shall must be carved out from the basic Medicaid health care benefits package.

(2) Specialty prepaid health plans are Medicaid managed care organizations as described in section 1903(m)(1)(A) of title XIX, 42 USC 1396b, and are responsible for providing defined inpatient services, outpatient hospital services, physician services, other specified Medicaid state plan services, and additional services approved by the Centers for Medicare and Medicaid Services under section 1915(b)(3) of title XIX, 42 USC 1396n.

(3) This section does Subsections (1) and (2) do not apply to a pilot project authorized under section 298(3) of article X of 2017 PA 107.

(4) Beginning on the effective date of the amendatory act that added this subsection, the department shall establish a fee-for-service payment for services provided by a physician, including an advanced practice provider, or nonphysician practitioner related to a primary diagnosis of alcohol use disorder as specified in the most recent diagnostic and statistical manual of mental disorders published by the American Psychiatric Association. When a Medicaid beneficiary has a primary diagnosis of alcohol use disorder, the physician, including an advanced practice provider or nonphysician practitioner qualifies for fee-for-service reimbursement for services including, but not limited to, evaluation and management services, and consultation services.

(5) As used in this section:

(a) "Advanced practice provider" means a health care provider with prescriptive authority under the public health code, 1978 PA 368, MCL 333.1101 to 333.25211.

(b) "Nonphysician practitioner" means an individual licensed or certified in this state to provide nonphysician behavioral health services including, but not limited to, behavioral health services identified in the department's behavioral health fee schedule.