AMOUNT OF FUNDING PAID TO PIHPs March 10, 2013

AMOUNT OF FUNDING PAID TO PIHPs
(FY2013 Appropriation Bill - Public Act 200 of 2012)
March 10, 2013
Section 418: On or before the tenth of each month, the department shall report to
the senate and house appropriations subcommittees on community health, the senate
and house fiscal agencies, and the state budget director on the amount of funding paid
to PIHPs to support the Medicaid managed mental health care program in the preceding
month. The information shall include the total paid to each PIHP, per capita rate paid
for each eligibility group for each PIHP, and number of cases in each eligibility group for
each PIHP, and year-to-date summary of eligibles and expenditures for the Medicaid
managed mental health care program.
Michigan's Medicaid Speciality Services and Supports Waiver
418 REPORT - FY2013
This report is provided in compliance with the Michigan Department of Community Health Appropriations Act, Sec. 418 which states: "On
or before the tenth of each month, the department shall report to the senate and house appropriations subcommittees on community
health, the senate and house fiscal agencies, and the state budget director on the amount of funding paid to PIHPs to support the Medicaid
managed mental health care program in the preceding month. The information shall include the total paid to each PIHP, per capita rate paid
for each eligibility group for each PIHP, and number of cases in each eligibility group for each PIHP, and year-to-date summary of eligibles
and expenditures for the Medicaid managed mental health care program."
The Michigan Department of Community Health operates a Medicaid prepaid specialty services managed care program through a 1915(b)
managed care waiver. This waiver operates concurrently with a 1915(c) Habilitation Supports Waiver (HSW). All Medicaid specialty mental
health, developmental disability and substance abuse services are provided through this program. Michigan's 46 community mental health
services programs have been consolidated into 18 Prepaid
Inpatient Health Plans (PIHPs) as proposed by the state and approved by the Center for Medicare and Medicaid Services
(CMS). The waiver is required to be implemented through the PIHP structure.
Note 1: Throughout the year PIHP capitation payments include recoupments or other payment adjustments for deceased recoveries, HSW
non-service recoupments and HSW retroactive eligibility or other payments or recoveries. The payments listed in this report include
adjustments. Adjustment details amounts are not separately reported. Calculation examples are provided on the Per Capita Cap Rates Paid
tab, and in those instances where adjustments have been made, the results from applying the examples' calculation methodology will not
reconcile to the amounts shown as paid.
Note 2: The Maternal and Child Health Integrated Program/Healthy Kids Expansion (MCHIP/HKE) Medicaid Eligible Group (MEG) is a subset
of the Temporary Aid for Needy Families (TANF) eligibility group that is paid at the same Per Capita Rate, and thus is not separately
reported.
Note 3: The FY2013-YTD section includes the months of October through the current pay period.
Note 4: The PIHPs and Affiliates section contains a full list of PIHPs and CMHSPs.
MEG Summary
Year-To-Date:
October 2012 through September 2013
Michigan's Medicaid Speciality Services and Supports Waiver
418 REPORT - FY2013
Capitation Paid (including adjustments)
PIHP
ACCESS ALLIANCE
CMH AFFILIATION OF MID MI
CMH FOR CENTRAL MICHIGAN
CMH PARTNERSHIP OF SE MI
DETROIT WAYNE PIHP
GENESEE COUNTY PIHP
LAKESHORE BEHAVIORAL HLTH ALLIANCE
LIFEWAYS PIHP
MACOMB PIHP
NETWORK 180
NORTH CARE
NORTHERN AFFILIATION
NORTHWEST CMH AFFILIATION
OAKLAND COUNTY PIHP
SAGINAW COUNTY PIHP
SOUTHWEST MI URBAN & RURAL CONSORTIUM
THUMB ALLIANCE
VENTURE BEHAVIORAL HEALTH
TOTAL
MH
24,329,324
34,031,702
17,773,821
27,871,678
141,116,576
33,905,879
21,840,702
11,765,484
54,099,032
35,798,820
22,222,249
18,729,570
17,751,401
76,954,748
14,929,063
27,614,514
21,567,036
29,562,681
$631,864,279
DAB
SA
236,336
319,229
189,134
326,569
3,937,136
686,874
261,476
148,869
762,620
443,167
184,490
224,454
188,101
621,879
266,368
347,059
187,523
275,464
$9,606,748
Combined
24,565,660
34,350,931
17,962,955
28,198,246
145,053,712
34,592,753
22,102,177
11,914,353
54,861,651
36,241,988
22,406,739
18,954,024
17,939,501
77,576,627
15,195,432
27,961,572
21,754,559
29,838,145
$641,471,026
TANF
201,941
342,057
143,216
284,699
1,501,809
315,317
232,179
126,039
412,117
353,920
146,064
156,440
151,865
412,621
132,650
269,400
170,020
307,683
5,660,037
DAB & TANF
290,276
481,311
210,554
394,756
2,176,344
451,916
319,340
177,707
576,753
492,260
218,995
230,440
217,346
605,114
200,792
373,883
230,333
436,843
8,084,963
MH
3,542,608
4,645,771
2,021,508
3,279,954
17,364,285
3,947,346
2,036,470
1,439,222
5,025,444
3,745,426
2,024,756
1,986,838
2,521,645
4,909,166
1,238,252
3,234,374
2,861,717
4,472,461
$70,297,243
Eligible Months Paid
PIHP
ACCESS ALLIANCE
CMH AFFILIATION OF MID MI
CMH FOR CENTRAL MICHIGAN
CMH PARTNERSHIP OF SE MI
DETROIT WAYNE PIHP
GENESEE COUNTY PIHP
LAKESHORE BEHAVIORAL HLTH ALLIANCE
LIFEWAYS PIHP
MACOMB PIHP
NETWORK 180
NORTH CARE
NORTHERN AFFILIATION
NORTHWEST CMH AFFILIATION
OAKLAND COUNTY PIHP
SAGINAW COUNTY PIHP
SOUTHWEST MI URBAN & RURAL CONSORTIUM
THUMB ALLIANCE
VENTURE BEHAVIORAL HEALTH
DAB
TOTAL
88,335
139,254
67,338
110,057
674,535
136,599
87,161
51,668
164,636
138,340
72,931
74,000
65,481
192,493
68,142
104,483
60,313
129,160
2,424,926
HSW
1,832
1,820
2,653
3,443
5,679
1,845
1,172
1,265
2,339
829
1,806
2,116
921
4,134
585
2,278
1,390
1,584
37,691
TANF
SA
379,282
453,696
213,585
436,028
1,518,314
732,656
407,609
245,851
818,267
504,020
266,646
284,356
267,427
763,991
295,291
432,446
270,788
438,383
$8,728,634
Combined
3,921,890
5,099,467
2,235,093
3,715,982
18,882,598
4,680,002
2,444,078
1,685,073
5,843,711
4,249,446
2,291,403
2,271,194
2,789,072
5,673,157
1,533,542
3,666,820
3,132,505
4,910,844
$79,025,877
MH
27,871,932
38,677,472
19,795,329
31,151,632
158,480,861
37,853,225
23,877,172
13,204,706
59,124,476
39,544,247
24,247,005
20,716,408
20,273,046
81,863,914
16,167,315
30,848,888
24,428,754
34,035,142
$702,161,522
DAB & TANF
SA
615,618
772,925
402,719
762,597
5,455,450
1,419,530
669,084
394,720
1,580,886
947,187
451,137
508,810
455,527
1,385,870
561,659
779,505
458,311
713,847
$18,335,382
Combined
28,487,550
39,450,398
20,198,048
31,914,229
163,936,310
39,272,755
24,546,256
13,599,426
60,705,362
40,491,434
24,698,142
21,225,218
20,728,573
83,249,784
16,728,974
31,628,393
24,887,064
34,748,989
$720,496,904
HSW
8,579,657
8,769,520
11,054,723
16,629,383
29,977,811
7,719,873
6,327,460
4,662,459
10,483,665
3,695,733
8,412,449
9,785,009
3,900,468
18,886,250
2,811,021
10,288,536
6,713,406
7,016,182
$175,713,606
Michigan's Medicaid Speciality Services and Supports Waiver
418 REPORT - FY2013
Monthly MEG Summary
Report Period: October 2012
Capitation Paid (including adjustments)
TOTAL
MH
4,871,839
6,794,299
3,546,291
5,581,931
28,287,955
6,794,851
4,364,274
2,347,756
10,783,499
7,201,549
4,445,309
3,726,003
3,567,960
15,370,480
2,988,450
5,510,583
4,311,700
5,929,718
$126,424,448
DAB
SA
47,290
63,685
37,734
65,334
788,207
137,585
52,255
29,652
152,030
89,216
36,831
44,630
37,715
124,063
53,247
69,201
37,511
55,212
$1,921,397
Combined
4,919,129
6,857,984
3,584,025
5,647,265
29,076,162
6,932,436
4,416,530
2,377,408
10,935,529
7,290,765
4,482,140
3,770,633
3,605,675
15,494,543
3,041,698
5,579,784
4,349,211
5,984,930
$128,345,845
TOTAL
DAB
17,663
27,766
13,439
22,008
134,907
27,300
17,408
10,306
32,649
27,827
14,574
14,722
13,153
38,403
13,629
20,868
12,042
25,901
484,565
TANF
40,316
68,200
28,436
56,861
299,215
62,702
46,347
25,208
81,738
70,655
29,128
30,975
30,449
82,905
26,531
53,956
33,964
61,670
1,129,256
DAB & TANF
57,979
95,966
41,875
78,869
434,122
90,002
63,755
35,514
114,387
98,482
43,702
45,697
43,602
121,308
40,160
74,824
46,006
87,571
1,613,821
PIHP
ACCESS ALLIANCE
CMH AFFILIATION OF MID MI
CMH FOR CENTRAL MICHIGAN
CMH PARTNERSHIP OF SE MI
DETROIT WAYNE PIHP
GENESEE COUNTY PIHP
LAKESHORE BEHAVIORAL HLTH ALLIANCE
LIFEWAYS PIHP
MACOMB PIHP
NETWORK 180
NORTH CARE
NORTHERN AFFILIATION
NORTHWEST CMH AFFILIATION
OAKLAND COUNTY PIHP
SAGINAW COUNTY PIHP
SOUTHWEST MI URBAN & RURAL CONSORTIUM
THUMB ALLIANCE
VENTURE BEHAVIORAL HEALTH
MH
707,965
926,423
401,801
654,843
3,461,164
785,537
407,139
288,017
997,402
747,654
404,038
393,358
506,124
986,056
247,912
647,695
572,093
896,516
$14,031,737
Eligible Months Paid
PIHP
ACCESS ALLIANCE
CMH AFFILIATION OF MID MI
CMH FOR CENTRAL MICHIGAN
CMH PARTNERSHIP OF SE MI
DETROIT WAYNE PIHP
GENESEE COUNTY PIHP
LAKESHORE BEHAVIORAL HLTH ALLIANCE
LIFEWAYS PIHP
MACOMB PIHP
NETWORK 180
NORTH CARE
NORTHERN AFFILIATION
NORTHWEST CMH AFFILIATION
OAKLAND COUNTY PIHP
SAGINAW COUNTY PIHP
SOUTHWEST MI URBAN & RURAL CONSORTIUM
THUMB ALLIANCE
VENTURE BEHAVIORAL HEALTH
HSW
371
365
538
691
1,128
364
233
253
470
164
362
423
185
827
117
453
272
319
7,535
TANF
SA
76,280
90,876
42,607
87,627
303,243
146,136
81,531
49,320
162,712
100,979
53,416
56,379
53,604
154,252
59,472
86,990
54,227
87,893
$1,747,543
Combined
784,245
1,017,299
444,408
742,470
3,764,407
931,674
488,670
337,336
1,160,114
848,632
457,455
449,737
559,728
1,140,308
307,384
734,686
626,320
984,409
$15,779,280
MH
5,579,804
7,720,722
3,948,092
6,236,774
31,749,119
7,580,388
4,771,413
2,635,773
11,780,901
7,949,203
4,849,348
4,119,361
4,074,084
16,356,536
3,236,363
6,158,279
4,883,793
6,826,234
$140,456,185
DAB & TANF
SA
123,570
154,561
80,341
152,960
1,091,450
283,721
133,787
78,971
314,742
190,194
90,247
101,009
91,319
278,315
112,719
156,191
91,738
143,105
$3,668,940
Combined
5,703,374
7,875,283
4,028,433
6,389,735
32,840,569
7,864,109
4,905,200
2,714,744
12,095,643
8,139,398
4,939,595
4,220,370
4,165,402
16,634,851
3,349,081
6,314,470
4,975,531
6,969,339
$144,125,126
HSW
1,747,568
1,729,320
2,252,073
3,349,266
5,919,471
1,519,480
1,257,015
932,365
2,139,989
733,435
1,687,193
1,964,992
777,368
3,736,517
548,794
2,042,062
1,318,222
1,424,818
$35,079,947
Michigan's Medicaid Speciality Services and Supports Waiver
418 REPORT - FY2013
Monthly MEG Summary
Report Period: November 2012
Capitation Paid (including adjustments)
PIHP
ACCESS ALLIANCE
CMH AFFILIATION OF MID MI
CMH FOR CENTRAL MICHIGAN
CMH PARTNERSHIP OF SE MI
DETROIT WAYNE PIHP
GENESEE COUNTY PIHP
LAKESHORE BEHAVIORAL HLTH ALLIANCE
LIFEWAYS PIHP
MACOMB PIHP
NETWORK 180
NORTH CARE
NORTHERN AFFILIATION
NORTHWEST CMH AFFILIATION
OAKLAND COUNTY PIHP
SAGINAW COUNTY PIHP
SOUTHWEST MI URBAN & RURAL CONSORTIUM
THUMB ALLIANCE
VENTURE BEHAVIORAL HEALTH
TOTAL
MH
4,846,432
6,762,967
3,545,767
5,540,423
27,985,837
6,739,259
4,360,612
2,348,653
10,720,927
7,158,183
4,431,232
3,713,021
3,530,230
15,260,040
2,981,688
5,499,251
4,304,648
5,885,935
$125,615,105
DAB
SA
46,994
63,407
37,765
65,003
780,987
136,518
52,194
29,721
151,295
88,617
36,813
44,497
37,418
123,451
53,189
69,129
37,493
54,899
$1,909,391
Combined
4,893,426
6,826,374
3,583,532
5,605,426
28,766,824
6,875,777
4,412,806
2,378,375
10,872,222
7,246,800
4,468,046
3,757,518
3,567,647
15,383,491
3,034,877
5,568,380
4,342,142
5,940,834
$127,524,496
TANF
40,147
67,966
28,483
56,483
298,278
62,735
46,292
25,093
81,917
70,680
28,944
31,016
30,284
82,101
26,461
53,706
33,777
61,275
1,125,638
DAB & TANF
57,776
95,702
41,945
78,423
432,617
89,952
63,695
35,419
114,673
98,372
43,504
45,787
43,374
120,478
40,096
74,555
45,854
87,060
1,609,282
MH
704,312
922,950
401,849
650,803
3,448,442
785,184
405,983
286,512
997,754
748,237
401,188
393,800
502,595
976,745
247,047
644,587
568,281
890,608
$13,976,876
Eligible Months Paid
DAB
PIHP
ACCESS ALLIANCE
CMH AFFILIATION OF MID MI
CMH FOR CENTRAL MICHIGAN
CMH PARTNERSHIP OF SE MI
DETROIT WAYNE PIHP
GENESEE COUNTY PIHP
LAKESHORE BEHAVIORAL HLTH ALLIANCE
LIFEWAYS PIHP
MACOMB PIHP
NETWORK 180
NORTH CARE
NORTHERN AFFILIATION
NORTHWEST CMH AFFILIATION
OAKLAND COUNTY PIHP
SAGINAW COUNTY PIHP
SOUTHWEST MI URBAN & RURAL CONSORTIUM
THUMB ALLIANCE
VENTURE BEHAVIORAL HEALTH
TOTAL
17,629
27,736
13,462
21,940
134,339
27,217
17,403
10,326
32,756
27,692
14,560
14,771
13,090
38,377
13,635
20,849
12,077
25,785
483,644
HSW
365
368
533
687
1,139
365
234
253
470
167
363
424
185
818
118
460
279
320
7,548
TANF
SA
75,391
89,970
42,300
86,592
301,402
145,789
81,153
48,941
162,476
100,902
52,822
56,093
53,213
151,939
58,678
86,121
53,531
87,097
$1,734,409
Combined
779,703
1,012,920
444,150
737,395
3,749,844
930,974
487,136
335,454
1,160,229
849,138
454,010
449,893
555,807
1,128,684
305,724
730,708
621,812
977,704
$15,711,285
MH
5,550,744
7,685,917
3,947,616
6,191,226
31,434,279
7,524,444
4,766,595
2,635,166
11,718,681
7,906,419
4,832,421
4,106,820
4,032,824
16,236,784
3,228,734
6,143,838
4,872,929
6,776,543
$139,591,982
DAB & TANF
SA
122,385
153,377
80,065
151,595
1,082,389
282,307
133,347
78,663
313,770
189,519
89,635
100,590
90,630
275,390
111,867
155,251
91,024
141,995
$3,643,800
Combined
5,673,129
7,839,294
4,027,682
6,342,821
32,516,668
7,806,751
4,899,942
2,713,828
12,032,451
8,095,938
4,922,056
4,207,410
4,123,454
16,512,175
3,340,601
6,299,088
4,963,953
6,918,538
$143,235,781
HSW
1,674,805
1,819,573
2,231,044
3,375,764
6,075,093
1,520,796
1,276,480
923,978
2,110,027
754,436
1,691,585
1,991,526
781,736
3,810,559
556,153
2,103,344
1,355,744
1,415,631
$35,468,276
Michigan's Medicaid Speciality Services and Supports Waiver
418 REPORT - FY2013
Monthly MEG Summary
Report Period: December 2012
Capitation Paid (including adjustments)
PIHP
ACCESS ALLIANCE
CMH AFFILIATION OF MID MI
CMH FOR CENTRAL MICHIGAN
CMH PARTNERSHIP OF SE MI
DETROIT WAYNE PIHP
GENESEE COUNTY PIHP
LAKESHORE BEHAVIORAL HLTH ALLIANCE
LIFEWAYS PIHP
MACOMB PIHP
NETWORK 180
NORTH CARE
NORTHERN AFFILIATION
NORTHWEST CMH AFFILIATION
OAKLAND COUNTY PIHP
SAGINAW COUNTY PIHP
SOUTHWEST MI URBAN & RURAL CONSORTIUM
THUMB ALLIANCE
VENTURE BEHAVIORAL HEALTH
TOTAL
MH
4,904,831
6,851,434
3,581,624
5,636,729
28,472,403
6,825,777
4,402,315
2,372,785
10,941,972
7,197,830
4,481,416
3,785,413
3,577,757
15,565,360
3,002,125
5,562,843
4,342,375
5,956,550
$127,461,540
DAB
SA
47,628
64,275
38,093
66,073
794,541
138,319
52,687
30,042
154,075
89,088
37,203
45,336
37,916
125,649
53,575
69,866
37,734
55,511
$1,937,613
Combined
4,952,459
6,915,709
3,619,717
5,702,802
29,266,944
6,964,096
4,455,002
2,402,827
11,096,047
7,286,919
4,518,619
3,830,749
3,615,674
15,691,009
3,055,701
5,632,709
4,380,109
6,012,061
$129,399,153
TANF
41,353
69,878
29,190
58,128
307,088
64,595
47,575
25,743
84,473
72,484
29,846
31,964
31,004
84,527
27,268
54,919
34,777
62,618
1,157,430
DAB & TANF
59,132
97,880
42,757
80,319
442,732
92,024
65,141
36,160
117,657
100,310
44,533
46,886
44,175
123,315
40,976
75,953
46,899
88,605
1,645,454
MH
725,404
948,978
411,904
669,774
3,550,292
808,344
417,416
294,016
1,030,112
767,407
413,235
406,025
514,608
1,005,450
254,386
659,323
585,141
909,982
$14,371,797
Eligible Months Paid
DAB
PIHP
ACCESS ALLIANCE
CMH AFFILIATION OF MID MI
CMH FOR CENTRAL MICHIGAN
CMH PARTNERSHIP OF SE MI
DETROIT WAYNE PIHP
GENESEE COUNTY PIHP
LAKESHORE BEHAVIORAL HLTH ALLIANCE
LIFEWAYS PIHP
MACOMB PIHP
NETWORK 180
NORTH CARE
NORTHERN AFFILIATION
NORTHWEST CMH AFFILIATION
OAKLAND COUNTY PIHP
SAGINAW COUNTY PIHP
SOUTHWEST MI URBAN & RURAL CONSORTIUM
THUMB ALLIANCE
VENTURE BEHAVIORAL HEALTH
TOTAL
17,779
28,002
13,567
22,191
135,644
27,429
17,566
10,417
33,184
27,826
14,687
14,922
13,171
38,788
13,708
21,034
12,122
25,987
488,024
HSW
367
359
531
687
1,145
372
237
255
476
168
362
423
185
828
117
458
275
317
7,562
TANF
SA
77,832
92,649
43,469
89,129
310,599
149,944
83,625
50,313
167,933
103,531
54,536
58,094
54,570
156,421
60,740
88,193
55,301
89,367
$1,786,245
Combined
803,236
1,041,626
455,373
758,904
3,860,891
958,288
501,041
344,328
1,198,045
870,938
467,771
464,119
569,177
1,161,871
315,126
747,516
640,442
999,349
$16,158,042
MH
5,630,235
7,800,412
3,993,529
6,306,503
32,022,694
7,634,121
4,819,731
2,666,801
11,972,084
7,965,238
4,894,652
4,191,438
4,092,365
16,570,810
3,256,511
6,222,166
4,927,517
6,866,533
$141,833,337
DAB & TANF
SA
125,460
156,924
81,562
155,203
1,105,140
288,263
136,312
80,354
322,008
192,619
91,739
103,431
92,486
282,069
114,316
158,059
93,035
144,877
$3,723,858
Combined
5,755,695
7,957,335
4,075,090
6,461,706
33,127,834
7,922,384
4,956,043
2,747,155
12,294,092
8,157,857
4,986,391
4,294,869
4,184,851
16,852,880
3,370,827
6,380,225
5,020,552
7,011,410
$145,557,195
HSW
1,702,890
1,717,812
2,215,290
3,280,961
5,969,046
1,593,915
1,278,148
950,085
2,131,698
750,144
1,672,177
1,914,548
774,859
3,751,309
548,210
2,048,147
1,299,631
1,395,243
$34,994,110
Michigan's Medicaid Speciality Services and Supports Waiver
418 REPORT - FY2013
Monthly MEG Summary
Report Period: January 2013
Capitation Paid (including adjustments)
TOTAL
MH
4,861,537
6,814,822
3,535,262
5,583,497
28,279,112
6,781,101
4,347,366
2,356,445
10,853,481
7,115,129
4,435,448
3,754,589
3,542,498
15,461,823
2,979,949
5,508,973
4,293,280
5,893,832
$126,398,142
DAB
SA
47,223
63,940
37,587
65,378
788,763
137,324
52,031
29,799
152,738
88,042
36,823
45,021
37,536
124,802
53,185
69,257
37,243
54,872
$1,921,564
Combined
4,908,760
6,878,763
3,572,849
5,648,874
29,067,874
6,918,425
4,399,397
2,386,244
11,006,219
7,203,171
4,472,271
3,799,610
3,580,034
15,586,625
3,033,134
5,578,230
4,330,523
5,948,704
$128,319,706
TOTAL
DAB
17,647
27,869
13,387
21,990
134,724
27,303
17,369
10,339
32,978
27,490
14,541
14,788
13,029
38,498
13,594
20,827
11,990
25,729
484,092
TANF
40,041
68,073
28,444
56,559
299,125
62,725
45,931
24,991
81,942
70,187
29,030
31,269
30,057
81,744
26,159
53,411
33,706
61,067
1,124,461
DAB & TANF
57,688
95,942
41,831
78,549
433,849
90,028
63,300
35,330
114,920
97,677
43,571
46,057
43,086
120,242
39,753
74,238
45,696
86,796
1,608,553
PIHP
ACCESS ALLIANCE
CMH AFFILIATION OF MID MI
CMH FOR CENTRAL MICHIGAN
CMH PARTNERSHIP OF SE MI
DETROIT WAYNE PIHP
GENESEE COUNTY PIHP
LAKESHORE BEHAVIORAL HLTH ALLIANCE
LIFEWAYS PIHP
MACOMB PIHP
NETWORK 180
NORTH CARE
NORTHERN AFFILIATION
NORTHWEST CMH AFFILIATION
OAKLAND COUNTY PIHP
SAGINAW COUNTY PIHP
SOUTHWEST MI URBAN & RURAL CONSORTIUM
THUMB ALLIANCE
VENTURE BEHAVIORAL HEALTH
MH
702,034
924,800
401,381
651,313
3,458,461
785,348
402,766
285,271
999,624
742,511
402,113
397,150
498,903
972,975
244,119
641,513
567,413
887,534
$13,965,229
Eligible Months Paid
PIHP
ACCESS ALLIANCE
CMH AFFILIATION OF MID MI
CMH FOR CENTRAL MICHIGAN
CMH PARTNERSHIP OF SE MI
DETROIT WAYNE PIHP
GENESEE COUNTY PIHP
LAKESHORE BEHAVIORAL HLTH ALLIANCE
LIFEWAYS PIHP
MACOMB PIHP
NETWORK 180
NORTH CARE
NORTHERN AFFILIATION
NORTHWEST CMH AFFILIATION
OAKLAND COUNTY PIHP
SAGINAW COUNTY PIHP
SOUTHWEST MI URBAN & RURAL CONSORTIUM
THUMB ALLIANCE
VENTURE BEHAVIORAL HEALTH
HSW
363
365
526
691
1,134
373
233
254
457
166
361
426
183
826
117
451
282
316
7,524
TANF
SA
74,796
90,294
42,443
86,308
302,340
145,527
80,669
48,649
162,469
99,567
52,668
56,871
52,893
151,080
58,100
85,655
53,720
86,937
$1,730,985
Combined
776,830
1,015,094
443,824
737,621
3,760,801
930,874
483,434
333,920
1,162,093
842,077
454,781
454,020
551,796
1,124,055
302,220
727,169
621,133
974,471
$15,696,214
MH
5,563,571
7,739,622
3,936,643
6,234,809
31,737,573
7,566,449
4,750,131
2,641,716
11,853,105
7,857,639
4,837,561
4,151,738
4,041,401
16,434,798
3,224,068
6,150,487
4,860,693
6,781,367
$140,363,371
DAB & TANF
SA
122,019
154,235
80,030
151,686
1,091,103
282,851
132,700
78,449
315,207
187,609
89,491
101,892
90,429
275,882
111,285
154,913
90,962
141,809
$3,652,550
Combined
5,685,589
7,893,857
4,016,673
6,386,495
32,828,676
7,849,299
4,882,831
2,720,164
12,168,312
8,045,248
4,927,053
4,253,630
4,131,830
16,710,680
3,335,353
6,305,399
4,951,656
6,923,175
$144,015,920
HSW
1,745,268
1,758,942
2,168,665
3,303,772
5,987,004
1,560,509
1,245,027
938,438
1,982,426
737,189
1,689,666
2,010,913
762,783
3,718,680
548,210
2,000,630
1,387,508
1,406,442
$34,952,072
Michigan's Medicaid Speciality Services and Supports Waiver
418 REPORT - FY2013
Monthly MEG Summary
Report Period: February 2013
Capitation Paid (including adjustments)
TOTAL
MH
4,844,684
6,808,179
3,564,877
5,529,098
28,091,270
6,764,891
4,366,135
2,339,844
10,799,152
7,126,129
4,428,844
3,750,545
3,532,956
15,297,045
2,976,851
5,532,864
4,315,033
5,896,644
$125,965,043
DAB
SA
47,201
63,923
37,955
64,781
784,638
137,128
52,308
29,655
152,482
88,204
36,819
44,969
37,516
123,914
53,171
69,605
37,542
54,971
$1,916,783
Combined
4,891,886
6,872,102
3,602,832
5,593,879
28,875,908
6,902,019
4,418,443
2,369,499
10,951,634
7,214,333
4,465,663
3,795,514
3,570,472
15,420,960
3,030,023
5,602,469
4,352,575
5,951,615
$127,881,826
TOTAL
DAB
17,617
27,881
13,483
21,928
134,921
27,350
17,415
10,280
33,069
27,505
14,569
14,797
13,038
38,427
13,576
20,905
12,082
25,758
484,601
TANF
40,084
67,940
28,663
56,668
298,103
62,560
46,034
25,004
82,047
69,914
29,116
31,216
30,071
81,344
26,231
53,408
33,796
61,053
1,123,252
DAB & TANF
57,701
95,821
42,146
78,596
433,024
89,910
63,449
35,284
115,116
97,419
43,685
46,013
43,109
119,771
39,807
74,313
45,878
86,811
1,607,853
PIHP
ACCESS ALLIANCE
CMH AFFILIATION OF MID MI
CMH FOR CENTRAL MICHIGAN
CMH PARTNERSHIP OF SE MI
DETROIT WAYNE PIHP
GENESEE COUNTY PIHP
LAKESHORE BEHAVIORAL HLTH ALLIANCE
LIFEWAYS PIHP
MACOMB PIHP
NETWORK 180
NORTH CARE
NORTHERN AFFILIATION
NORTHWEST CMH AFFILIATION
OAKLAND COUNTY PIHP
SAGINAW COUNTY PIHP
SOUTHWEST MI URBAN & RURAL CONSORTIUM
THUMB ALLIANCE
VENTURE BEHAVIORAL HEALTH
MH
702,894
922,620
404,572
653,221
3,445,925
782,933
403,166
285,407
1,000,553
739,618
404,181
396,506
499,416
967,940
244,788
641,255
568,788
887,821
$13,951,604
Eligible Months Paid
PIHP
ACCESS ALLIANCE
CMH AFFILIATION OF MID MI
CMH FOR CENTRAL MICHIGAN
CMH PARTNERSHIP OF SE MI
DETROIT WAYNE PIHP
GENESEE COUNTY PIHP
LAKESHORE BEHAVIORAL HLTH ALLIANCE
LIFEWAYS PIHP
MACOMB PIHP
NETWORK 180
NORTH CARE
NORTHERN AFFILIATION
NORTHWEST CMH AFFILIATION
OAKLAND COUNTY PIHP
SAGINAW COUNTY PIHP
SOUTHWEST MI URBAN & RURAL CONSORTIUM
THUMB ALLIANCE
VENTURE BEHAVIORAL HEALTH
HSW
366
363
525
687
1,133
371
235
250
466
164
358
420
183
835
116
456
282
312
7,522
TANF
SA
74,982
89,907
42,766
86,372
300,730
145,260
80,631
48,628
162,677
99,042
53,204
56,919
53,147
150,299
58,301
85,487
54,010
87,090
$1,729,452
Combined
777,876
1,012,527
447,338
739,593
3,746,655
928,193
483,797
334,035
1,163,229
838,660
457,385
453,425
552,563
1,118,240
303,089
726,742
622,798
974,911
$15,681,055
MH
5,547,578
7,730,799
3,969,449
6,182,319
31,537,196
7,547,824
4,769,301
2,625,251
11,799,705
7,865,747
4,833,024
4,147,051
4,032,372
16,264,985
3,221,639
6,174,119
4,883,821
6,784,465
$139,916,647
DAB & TANF
SA
122,183
153,830
80,721
151,153
1,085,367
282,388
132,938
78,283
315,159
187,246
90,024
101,888
90,663
274,214
111,472
155,091
91,552
142,061
$3,646,235
Combined
5,669,762
7,884,629
4,050,170
6,333,472
32,622,563
7,830,212
4,902,240
2,703,534
12,114,864
8,052,994
4,923,048
4,248,939
4,123,035
16,539,199
3,333,112
6,329,211
4,975,373
6,926,526
$143,562,882
HSW
1,709,126
1,743,873
2,187,652
3,319,620
6,027,198
1,525,173
1,270,790
917,593
2,119,525
720,528
1,671,828
1,903,030
803,723
3,869,185
609,654
2,094,353
1,352,302
1,374,047
$35,219,200
Specialty Services Waiver
State Plan (b) & Alternative (b)(3) Services Capitation Rates
Effective October 1, 2012
State of Michigan
Department of Community Health
For (b) and (b)(3) Capitation Rates:
Service and Population
TANF Mental Health
DAB Mental Health
TANF Substance Abuse
DAB Substance Abuse
Service and Population
Mental Health - TANF
Male
Female
Statewide Capitation Rates
Capitation Rate [a.k.a. "per capita rate paid for each eligibility group for each PIHP]" = Base Rate + Tax * AgeGender Factor * Geographic Factor
Claims Tax Amount
State Plan
1915(b)(3)
$0.11
$0.00
$1.30
$1.10
No Taxes
State Plan 1915(b)(3)
$11.69
$0.60
$144.06
$112.35
$0.99
$2.39
0 - 17
$0.01
$0.02
$0.53
$1.47
18 - 25
SFY 2013 Age / Gender Factors (State Plan)
26 - 39
40 - 49
50 - 64
65+
0 - 17
$0.01
$0.01
18 - 25
SFY 2013 Age / Gender Factors (B3)
26 - 39
40 - 49
50 - 64
65+
1.0801
0.7520
1.0368
0.9787
1.1256
1.3221
1.1711
1.7031
1.1345
1.4755
0.0051
0.0051
1.1362
0.6553
0.6899
0.7939
0.9985
1.3799
1.4567
2.4482
1.6373
2.6422
0.0145
0.0145
Mental Health - DAB
Male
Female
0.7448
0.5512
1.1596
0.8681
1.6187
1.3051
1.8339
1.3807
1.4514
1.0856
0.4800
0.2677
0.1352
0.0968
0.7326
0.5374
2.6768
1.9180
2.1527
1.3680
1.6687
1.0878
0.6181
0.2997
Substance Abuse - TANF
Male
Female
0.3111
0.1361
1.8791
2.1205
3.6644
3.3977
3.3059
4.1764
3.0035
4.2491
0.0173
0.0173
Substance Abuse - DAB
Male
Female
0.2107
0.0718
1.1044
0.8942
1.3860
1.5727
2.0532
1.7315
2.5102
1.1448
0.1323
0.0276
State Fiscal Year 2013 Geographic Factors
PIHP Name
Lakeshore Affiliation
CMH for Central Michigan
Access Alliance
Southeast Partnership
Southwest Alliance
Saginaw
Genesee
CMH Affiliation of Mid-Michigan
Detroit-Wayne
North Care
Lifeways
Macomb
Oakland
Thumb Alliance
CMHSA Network of West Michigan
Venture
North Country
Northern Lakes
Mental Health
TANF
DAB
0.7142
0.9713
1.1374
0.9746
1.4210
1.0242
0.9301
0.9743
0.9734
1.0190
0.7492
0.8074
1.0027
0.9040
1.0961
0.9404
0.9244
0.7914
1.1210
1.2081
0.9243
0.8684
0.9729
1.3522
0.9544
1.6333
1.3545
1.3679
0.8648
0.9874
1.1803
0.8837
1.0291
0.9696
1.3465
1.0360
Substance Abuse
TANF
DAB
1.2597
0.7709
0.9341
0.6714
1.2332
0.6474
1.0297
0.7563
1.1008
0.8459
1.4231
0.9313
1.4103
1.1725
0.8653
0.5830
0.6282
1.4053
1.2354
0.6668
1.2840
0.7208
1.2367
1.2768
1.2125
0.8882
1.0271
0.7755
1.0591
0.8186
0.9580
0.5409
1.2146
0.7495
1.1716
0.7121
MH St. Plan
MH (b)(3)
MH St. Plan
MH (b)(3)
SA St. Plan
SA (b)(3)
Example 1: Access Alliance DAB Male, age 55
Base
Tax
Age/Gender GeoFactor
$144.06
$1.30
1.4514
1.0242
$112.35
$1.10
1.6687
1.0242
MH Total
Example 2: Detroit Wayne DAB Female, age 42
Base
Tax
Age/Gender GeoFactor
$144.06
$1.30
1.3807
0.7914
$112.35
$1.10
1.3680
0.7914
MH Total
Example 3: Venture TANF Female, age 25
Base
Tax
Age/Gender GeoFactor
$0.99
$0.01
2.1205
0.9580
$0.53
$0.01
2.1205
0.9580
SA Total
=
=
=
CapRate
$216.08
$193.90
$409.98
=
=
=
$158.83
$122.82
$281.66
=
=
=
$2.03
$0.52
$2.55
To avoid problems with transmitting data in HIPAA compliant formats, all capitation rates are set to a minimum of $0.01.
State of Michigan
Specialty Services Waiver
Waiver C Capitation Rates
Rates Effective October 1, 2012
Capitation Rate [a.k.a. "per capita rate paid for the Waiver C eligibility group for each PIHP]" = Base Rate + Tax + Residential Living
Arrangement Additive X Multiplicative Factor + Mt Pleasant Additive [for enrollees discharged from MPC on or after 10-1-07]
Note: Waiver C rates are calculated based on County of Residence and Paid to County of Financial Responsibility
No Taxes
$1,672.67
Claims Tax Amount
$16.38
Additive Parameter - Residential Living Arrangement
Supported Independence Program
Private Residence with Spouse or Non-Family
Specialized Residential Home
Private Residence with Family or Foster Family Home
$ 4,069.71
4,386.47
$2,453.76
$1,869.54
$39.89
$42.98
$24.04
$18.32
Mt. Pleasant MVA
$8,127.80
Rate Development Base:
Multiplicative Parameter - PIHP
Lakeshore Affiliation
CMH for Central Michigan
Access Alliance
Southeast Partnership
Southwest Alliance
Saginaw
Genesee
CMH Affiliation of Mid-Michigan
Detroit-Wayne
North Care
Lifeways
Macomb
Oakland
Thumb Alliance
CMHSA Network of West Michigan
Venture
North Country
Northern Lakes
1.1917
0.8600
1.0012
0.9733
0.9674
1.0258
0.9483
1.0292
0.9867
1.1014
0.8534
0.9672
0.9868
1.0949
1.0363
0.9514
0.9853
0.9660
Example 1: Access Alliance non-MPC SIP enrollee who lives in Bay Co.,
Base
$1,672.67
Tax
$16.38
RLA
$4,109.60
MultiFactor
1.0012
MPC
0
=
CapRate
$5,805.61
Example 2: Saginaw 9-1-09 MPC-Exit who resides in in a Spec Res Facility in Saginaw Co.,
Use Tax Only
Tax
Base
RLA
MultiFactor
MPC
CapRate
$1,672.67
$16.38 $2,477.80
1.0258 $8,127.80
=
$12,402.15
Example 3: Saginaw 4-1-09 MPC-Exit who resides in a Foster Family home in Bay Co.,
Use & Claims Tax
Tax
Base
RLA
MultiFactor
MPC
CapRate
$1,672.67
$16.38 $1,887.86
1.0012 $8,127.80
=
$11,709.00