Responsibilities and standards news
Secret shopper survey assessing appointment wait times launches soon
We’re partnering with Press Ganey to launch a secret shopper survey that evaluates in-person and virtual appointment-scheduling wait times for provider offices that accept patients covered under our ACA/marketplace plans.
January 20, 2026
EVV required for select home health care Medicaid services beginning Jan. 1, 2026
Beginning Jan. 1, 2026 the Michigan Department of Health and Human Services (MDHHS) will require Medicaid claims containing select home health care service (HHCS) codes to be submitted using Electronic Visit Verification (EVV). This requirement applies to all applicable claims submitted with a date of service on or after Sept. 3, 2024.
December 19, 2025
Final reminder: You must complete our D-SNP Model of Care training by Dec. 31
Providers play an integral role in the care teams that support our dual-eligible special needs (D-SNP) members. That's why the Centers for Medicare and Medicaid Services (CMS) requires us to make sure providers who are contracted with us to see PriorityMedicare patients are trained on our Model of Care (MOC) every year.
December 11, 2025
November 2025 medical policy updates
Our Medical Affairs Committee (MAC), comprised of Priority Health network physicians, met in November and approved the following medical policy updates.
November 20, 2025
11/13/2025: Reminder: You must complete our D-SNP Model of Care training by Dec. 31
Providers play an integral role in the care teams that support our dual-eligible special needs (D-SNP) members. That's why the Centers for Medicare and Medicaid Services (CMS) requires us to make sure providers who are contracted with us to see PriorityMedicare patients are trained on our Model of Care (MOC) every year.
November 5, 2025
10/15/2025 Reminder: You must complete our D-SNP Model of Care training by Dec. 31
Providers play an integral role in the care teams that support our dual-eligible special needs (D-SNP) members. That's why the Centers for Medicare and Medicaid Services (CMS) requires us to make sure providers who are contracted with us to see PriorityMedicare patients are trained on our Model of Care (MOC) every year.
October 15, 2025
9/2/2025: Reminder: You must complete our D-SNP Model of Care training by Dec. 31
Providers play an integral role in the care teams that support our dual-eligible special needs (D-SNP) members. That's why the Centers for Medicare and Medicaid Services (CMS) requires us to make sure providers who are contracted with us to see PriorityMedicare patients are trained on our Model of Care (MOC) every year.
September 2, 2025
New Provider Education Module: Updating your Find a Doc information in prism
How to update FAD provider information in prism
August 20, 2025
August 2025 medical policy updates
Our Medical Affairs Committee (MAC), comprised of Priority Health network physicians, met in August and approved the following medical policy updates. Unless otherwise noted, the changes will go into effect on Sept. 1, 2025.
August 18, 2025
Change to ACN enrollment rules
Effective July 8, 2024, we’ll no longer allow providers to be enrolled under more than one ACN contract at a time under the same NPI, TIN and address. This includes ACNs with both direct and delegated contracts.
August 13, 2025