Clarification of LOCD COVID-19 Public Health Emergency Unwind (SNF)

The Michigan Department of Health and Human Services previously issued two L-letters — L 23-23 and L 23-28 — providing guidance for Levels of Care Determinations (LOCD) at the termination of the public health emergency (PHE).  

• L 23-23 contains guidance on the end of flexibilities used during the PHE and how to resume LOCD policy as stated in the Medicaid Provider Manual. MDHHS states that nursing facilities must not prioritize residents based on assumptions that the residents have become ineligible during the PHE and must only have their LOCD eligibility reviewed due to a new significant change of condition, scheduled assessment, or shortly prior to the end date of the current LOCD record. Nursing facilities must thoroughly evaluate for all LOCD doors, including Door 7 (service dependency). Providers should review and reference L 23-23 for guidance on how to resume normal LOCD operations and policy.
• L 23-28 unwinds a previous letter — L 20-59. It applies only to nursing facility residents who had a Door 0 conducted and entered into CHAMPS between December 3, 2019, and February 29, 2020 (a very small number of impacted individuals). It also provides the process for nursing facilities to request payments for dates of service during the LOCD Door 0 appeal timeframe. 

 Questions? Email Provider Support or call (800) 292-2550.