We are preparing for our 2025 HEDIS Hybrid Project that will run from January 2026 to April 2026. Your office may be contacted during this timeframe for records with dates of service in 2025 and prior that were not already captured by claims.
Flu season is approaching, and vaccinations remain one of the most effective ways to protect patients and communities.
The Michigan Medicaid SPDL Formulary has been updated as of 8/1/2025.These changes include drugs that have been added, removed, or had utilization management restrictions adjusted for preferred and non-preferred medications
The coverage of certain insulin syringes and pen needle products is changing on 08/01/2025 for all members. Effective on 08/01/2025, insulin syringes and pen needles other than Embecta (formerly known as B.D.) branded products will be removed from the formulary.
Hepatitis C Virus Program: The recommended treatment for HCV is Mavyret, which can be dispensed in eight- week supply. Providers who have prescriptive authority can prescribe Mavyret to their patients with a positive Hepatitis C diagnosis. Prior authorization is not required for Medicaid.
Medicare-Medicaid Plan (MMP) Dedicated Care Management: All MMP members have a dedicated care manager who is a registered nurse or licensed social worker assigned to support them with their health care needs, navigating the health care system, and assisting with resources for SDoH needs. For more information call 1-855-323-4578 or contact provider relations via our Provider Relations Inquiry Form.
