Reminder: You must complete our CMS-required HIDE-SNP and D-SNP Model of Care training by Dec. 31
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.
Providers may receive requests for HIDE-SNP member medical records
As part of the Priority Health Medical Record Review (MRR) process, we’re sending out requests to some providers in our Medicare and Medicaid network for PriorityMedicare Dual Premier members. Follow the instructions in the letter to return all requested medical records within 30 days.
New Medicaid-only credentialing form now available
Starting Oct. 1, 2026, new individual providers enrolling with Priority Health for Medicaid only will use a new standardized credentialing and enrollment form. This change is in alignment with the Michigan Department of Health and Human Services (MDHHS) new requirements for Michigan’s Medicaid Health Plans[JW2.1] (MHPs).
ETS exclusivity expanding to Medicare and Medicaid
Effective Oct. 1, 2026, Emerging Therapy Solutions (ETS) will be Priority Health’s exclusive vendor for bone marrow transplants, organ transplants and CAR T-cell and gene therapies. This will be in effect across all lines of business, now including Medicare and Medicaid. ETS will reach out to all Michigan hospitals they’re currently contracted with about expanding the agreement to include Medicare and Medicaid.
Reminder: Access to care standards apply
We’re committed to helping members access care when they need it – 24 hours a day, seven days a week. We expect providers to follow the appointment and timely access to care standards outlined in the Priority Health Plan provider contracts .
Reminder: You must complete our CMS-required HIDE-SNP and D-SNP Model of Care training by Dec. 31
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.
August 2026 medical policy updates
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
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
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
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
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
The MY 2025 HEDIS audit closes this month