Responsibilities and standards news

Reminder: You must complete our CMS-required HIDE-SNP and D-SNP Model of Care training by Dec. 31
August 17, 2026

Providers play an integral role in the care teams that support our special needs plans (SNPs) 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 Medicare or Medicaid members are trained on our Model of Care (MOC) every year.

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August 2026 medical policy updates
August 11, 2026

Our Medical Affairs Committee (MAC), comprised of Priority Health network physicians, met in August and approved the following medical policy updates.

Reminder: You must complete our CMS-required HIDE-SNP and D-SNP Model of Care training by Dec. 31
June 22, 2026

Providers play an integral role in the care teams that support our special needs plans (SNPs) 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 Medicare or Medicaid members are trained on our Model of Care (MOC) every year.

May 2026 medical policy updates
May 20, 2026

Our Medical Affairs Committee (MAC), comprised of Priority Health network physicians, met in May and approved the following medical policy updates.

2026 HIDE-SNP and D-SNP Model of Care training is now required for Medicare and Medicaid providers
April 23, 2026

Providers play an integral role in the care teams that support our special needs plans (SNPs) 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 Medicare or Medicaid members are trained on our Model of Care (MOC) every year.

3/30/2026: MDHHS Mental Health Framework training reminder
March 30, 2026

As part of the state’s Mental Health Framework initiative, behavioral health providers contracted with Medicaid are required to complete assessment training for the Michigan Child and Adolescent Needs and Strengths (MichiCANS) Screener and the Level of Care Utilization System (LOCUS) as soon as possible.

The MY 2025 HEDIS audit closes this month
March 30, 2026

The MY 2025 HEDIS audit closes this month

Reminder: Appointment wait-time standards apply
March 16, 2026

Did you know that the Centers for Medicare and Medicaid Services (CMS) sets appointment wait-time standards for provider offices and then, they are monitored for adherence to these requirements through secret shopper surveys?

February 2026 medical policy updates
February 10, 2026

Our Medical Affairs Committee (MAC), comprised of Priority Health network physicians, met in February and approved the following medical policy updates.

2026 HIDE-SNP and D-SNP Model of Care training is now available and required for Medicare and Medicaid providers
January 30, 2026

Providers play an integral role in the care teams that support our special needs plans (SNPs) 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 Medicare or Medicaid members are trained on our Model of Care (MOC) every year. Our 2026 HIDE-SNP & D-SNP MOC training is now available.

Annual HEDIS audit begins soon
January 20, 2026

The 2025 MY HEDIS audit begins soon.

Secret shopper survey assessing appointment wait times launches soon
January 20, 2026

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.