Michigan
LLC
Website link to register:
https://www.michigan.gov/lara/bureau-list/cscl
Naming conventions
Certain terms like “Bank” or “Insurance” require licensing. Must include “Limited Liability Company,” “LLC,” or “L.L.C.” Professional services must use “PLLC.”
Licensing Requirements
Submit proof of medical licensure from the Michigan Board of Medicine. Proof of malpractice insurance required. Comply with Michigan Department of Licensing and Regulatory Affairs facility standards.
Required documentation for medical practices
Articles of Organization, Michigan Facility Compliance, Professional Licenses, Malpractice Insurance
Filing Fee: $50
Annual/Biennial Fee: $25
Additional Notes: Annual report due February 15.
Medicaid
Program Name: Michigan Medicaid
Official Website: http://michigan.gov/mdhhs/assistance-programs/medicaid
Legislation: Michigan passed SB 69 in 2019, recognizing DPC agreements as not being insurance and exempting them from state insurance laws.
Private Contracting
Explicitly permitted; DPC agreements are recognized and not subject to state insurance laws.
Restrictions
No explicit restrictions for DPC providers; compliance with federal and state regulations is required.
Medicaid Program
Michigan Medicaid provides health coverage to eligible low-income residents, including children.
Notification Requirements
Notification strongly recommended to avoid confusion.
Provider Enrollment Requirements
Providers must enroll with Delaware Medicaid to serve beneficiaries directly or offer reimbursable Providers must enroll with Michigan Medicaid to serve beneficiaries directly or offer reimbursable services.services.
Enrollment Options
No "Ordering and Referring Only" status available.
Ordering, Referrals, and Testing
Non-enrolled providers may face challenges with Medicaid recognition for orders and referrals.
Designated PCP Restrictions
DPC physicians cannot act as Medicaid-designated PCPs.
Billing and Reimbursement
DPC practices typically do not bill Medicaid for services covered under private agreements.
Managed Care Plan Exemptions
Not specified.
Billing Clarity
Cannot bill Medicaid patients for covered services unless explicitly outlined.
CMS Guidance
CMS informational bulletins recommend clarity on private contracting rules.
Opportunities for Collaboration
Opportunities may exist to collaborate with Medicaid Managed Care Organizations (MCOs) or state initiatives focused on innovative care delivery.
State-Specific Notes
Collaboration possible with Michigan Medicaid Managed Care Organizations for primary care expansion.
Dispensing Medication
Board of Pharmacy Official Link:
https://www.michigan.gov/lara/bureau-list/bpl/health/hbp/pharmacy
State Licensing
Physicians must register with the Michigan Department of Licensing and Regulatory Affairs for dispensing controlled substances.
Scope of Practice
Physicians may dispense medications directly; controlled substances require strict adherence to state and federal laws.
Inventory Management
Maintain accurate inventory logs with secure storage for controlled substances.
Record-Keeping
Records must be HIPAA-compliant and adhere to Michigan state standards.
Dispensing Standards
Labels must meet Michigan Board of Pharmacy guidelines, including detailed usage instructions.
Controlled Substances
DEA registration and reporting to Michigan’s MAPS system are mandatory for controlled substances.
Billing and Reimbursement
Billing practices must comply with federal anti-kickback statutes and Michigan-specific regulations.
Federal Compliance
Compliance with federal DEA, FDA, and OSHA standards is required.
State Pharmacy Laws
Physicians must comply with Michigan Board of Pharmacy rules for controlled substances dispensing.
Patient Consent
Patients must provide informed consent before medications are dispensed.
Insurance and Liability
Physicians must ensure liability insurance covers risks related to dispensing.
Training Requirements
Continuing education for dispensing controlled substances is required in Michigan.
Audits and Inspections
Inspections by Michigan’s Department of Licensing and Regulatory Affairs are routine, with penalties for violations.