Bulletins
This is where you’ll find bulletins about updates and revisions to Meridian for the Medicare-Medicaid Plan (MMP) and Medicaid lines of business.
See also:
Ambetter from Meridian Provider Notifications | Michigan Wellcare Provider Notifications
Latest Updates:
May Monthly Provider Update (PDF)
Supplemental Materials (All LOBs)
- Reference Guide: Appeals/Reconsiderations vs. Corrected Claims
- Level of Care Claims Processing Reminder
- Measurement Year 2025 (MY 2025) HEDIS® Behavioral Health Measure Specification Updates
- National Kidney Foundation of Michigan (NKFM) Programs
Meridian (Medicaid) Supplemental Materials
- Medicaid Member Balance Billing
- UPIC Medicaid Audit Notification
- 2025 Interqual Criteria Updates (PDF)
- Outpatient Prior Authorization Requirement Updates (Effective 7/1/2025)
- May 2025 Michigan Medicaid Single Preferred Drug List (SPDL) Formulary Changes
- Insulin Syringe & Pen Needles Changes Effective 8/1/2025
- Public Comments to MDHHS on Michigan Medicaid Common Formulary/Single Preferred Drug List Q2 2025
- Diabetic Supply Reference Guide (Updated for 2025)
Upcoming Events
- Monthly Provider Webinar Schedule
- Provider Network Bi-Weekly Orientation Schedule
- Introduction to Adverse Childhood Experiences and Trauma-Informed Care Webinar (PDF)
Make sure to check Ongoing Reminders for important information from recent bulletins you may have missed, along with our archive below!
Past Bulletins:
April Monthly Provider Update (PDF)
4/10/2025 - Encounters Edit 5169 Error –FQHCs
Supplemental Materials (All LOBs)
- Updated Clinical Practice Guidelines (CPGs) Now Available
- Recommendations for Hepatitis C Testing Among Perinatally Exposed Infants and Children (CDC YouTube)
- National Network of STD Clinical Prevention Training Centers (NNPTC.org)
Meridian Supplemental Materials (Medicaid LOB)
- Low Birth Weight Project Flyer (PDF)
- MDHHS Pregnancy Management Measures
- Racial Disparities in Chlamydia Screening for Women (CHL)
- Optimizing Community Engagement in Healthcare | Three Day Seminar
- Clinical Policy Updates
March Monthly Provider Update (PDF)
Supplemental Materials (Market-wide)
- Physician Self-Referral (42 U.S.C. § 1395nn) (CMS.gov)
- National Kidney Month
Meridian Supplemental Materials (Medicaid LOB)
- VFC Resources
- Prior Authorization Updates (Effective April 20-21, 2025)
- Members Empowered to Succeed (METS) Program Details
Recent Updates
- Update (3/10/2025): Out-of-Network Provider Prior Authorization Requirement
- Update (3/6/2025): Policy Revisions Effective 4/15/2025
- Update (3/3/2025): Vendor Transition - 6 Degrees Health
February Monthly Provider Update (PDF)
Supplemental Materials (All LOBs)
- Heart Health Coaching Program
- Pediatric Oral Health Online Resources
- Meridian's Patient Experience Provider Summit Registration
- KED Education Flyer (PDF)
Supplemental Materials (Meridian Medicaid)
- Q1 Public Comments to MDHHS on Michigan Medicaid Common Formulary
- Updated Clinical Policies (Effective 3/28/2025)
Update (2/14/2025): Clinical Policy CP.MP.50 - Drugs of Abuse Additional Review
January Monthly Provider Update (PDF)
Supplemental Materials (All LOBs)
- KED Resources (kidney.org)
- MC3 Webinar Details
- Barrier Removal Fund Details
Supplemental Materials (Meridian Medicaid)
New (10/30/2024): Upcoming Availity Essentials Live Training for Meridian Providers
December Monthly Provider Update (PDF)
Supplemental Materials (All LOBs)
Self Service Tools:
- New Provider Contract Form
- Practitioner Enrollment Form
- Demographic Update Form
- Provider Portal (Claims, Authorizations, Member Eligibility)
Supplemental Materials (Meridian Medicaid)
New (10/30/2024): Upcoming Availity Essentials Live Training for Meridian Providers
UPDATED (11/20/24): Behavioral Health Outpatient Billing Configuration Changes
November Monthly Provider Update (PDF)
Pediatric Provider Newsletter | Fall 2024 (PDF)
Supplemental Materials (All LOBs)
Supplemental Materials (Meridian Medicaid)
- ACEs Overview Webinar Details (PDF)
- Medical Record Review Details
- Medicaid Claims and Billing Guide
- Public Comment on MDHHS Medicaid Health Plan Common Formulary Details
New (10/30/2024): Upcoming Availity Essentials Live Training for Meridian Providers
October Monthly Provider Update (PDF)
Pediatric Provider Newsletter | Fall 2024 (PDF)
Supplemental Materials (All LOBs)
- Redesigned Current Practitioner Enrollment and Updates Forms
- HEDIS® Hybrid Project Details
- Ambetter Health Day Flyer (PDF)
Supplemental Materials (Meridian Medicaid)
- Strategies to Prevent Healthcare-Associated Infections
- Provider Portal Link for SDoH Assessment Form
- HIV Pre-exposure Prophylaxis (PrEP) Education and Resources
Medicaid Prior Authorization Requirement Updates
September Monthly Provider Update (PDF)
Supplemental Materials (All LOBs)
Supplemental Materials (Meridian Medicaid)
- Access and Availability Audit Details
- Hepititis C Virus Program Details
- PIHP Details - MDHHS Bulletin MMP 23-61
- LGBTQ+ Wellbeing | Resources and Data
- MC3 Services Overview
- Logical Observation Identifiers, Names, and Codes (LOINC)
- Medicaid Prior Authorization Requirement Updates
- Reduction Mammoplasty Medical Policy Update
Supplemental Materials (MMP)
MeridianComplete My Meridian Rewards Program
August Monthly Provider Update (PDF)
Supplemental Materials (All LOBs)
- Provider Race and Ethnicity Disclosure Initiative (PDF)
- Anti-Kickback Statute - Details (PDF)
- Electronic Visit Verification (EVV) Details and FAQs
Supplemental Materials (Meridian Medicaid)
- New (8/28/24): Service Area Change Notice (PDF)
- Updated Medicaid Prior Authorization Requirement: Abortion Services
- Inpatient Prior Authorization Fax/Mail Form (PDF)
- Mae Health - Doula Resources
- Appropriate Use of GLP-1 Agonists - Details
- MC3 Clinical Pearls Web Video Series - Details
- Respiratory Syncytial Virus (RSV) Notice - Details
- MDHHS Proposed Policy: Termination of COVID-19 Laboratory Policies- MDHHS Policy Proposal Link (PDF)
Upcoming Events
- Michigan ACE Initiative Webinar: Introduction to Adverse Childhood Experiences and Trauma Informed Care (PDF)
September 9, 2024 | 12:00 - 1:00 pm ET - August 2024 MI Provider Workshop – Okemos, MI
Update: This workshop has been cancelled, stay tuned for future workshop announcements. - Monthly Provider Webinar Schedule (PDF) - next event September 4
Provider Network Bi-Weekly Orientation Schedule (PDF) - next events Thursday August 22 (12pm) and Tuesday September 10 (8am)
July Monthly Provider Update (PDF)
Supplemental Materials (All LOBs)
- Pemibivart Prior Auth Details - MDHHS Bulletin MMP 23-27 (PDF)
- Provider Satisfaction Survey Details (PDF)
- Improving Pressure Injury Prevention and Management Details
- Intravenous Hydration Education (PDF)
- Medicaid Diabetic Supply Information Reference Guide
- Cribs and Car Seats Program Printable Flyer (PDF)
June Monthly Provider Update (PDF)
Supplemental Materials
- Change in Sleep Study and Wound Care Prior Authorization Requirements Effective July 15, 2024
- Change in PLA and Category II Code Prior Authorization Requirements Effective July 17, 2024
- Pediatric Lead Screenings - MDHHS MI Lead Safe Program
Upcoming Events
- Northern MI Provider Symposium Info (PDF)
- Monthly Provider Webinar Schedule (PDF) - next event July 3
- Provider Network Bi-Weekly Orientation Schedule (PDF) - next events Thursday June 27 and Tuesday July 9
May 2024 - MI Monthly Provider Update (PDF)
- Change In Tonsillectomy and Adenoidectomy Prior Authorization Requirements
- Annual CAHPS Survey/Quality Program Overview
- CDC STEADI Program
- Inpatient Authorization Form Reminder - Manuals, Forms, and Resources Page
Evolent Management Program Updates
- Evolent Oncology Quality Management Change Notification
- Evolent Oncology Quality Management - Frequently Asked Questions
- Evolent Cardiology Management Program Change Notification
- Evolent Cardiology Management Program - Frequently Asked Questions
April 2024 - MI Monthly Provider Update (PDF)
Concert Genetic Testing Policy Update
Meridian and MeridianComplete Transition to SafeRide Health for Transporatation Benefits
CDC Talk Test Treat Campaign Materials
National Network of STD Clinic Prevention Training Center
Change Healthcare Outage Updates
Submission requirements for unlisted or not otherwise
classified (NOC) codes - Supplemental Materials
Fax Submission of Appeals - Supplemental Materials
- New Fax Submission Process Details
- Meridan Appeal Cover Letter (PDF)
- MeridianComplete Appeal Cover Letter (PDF)
March 2024 - MI Monthly Provider Update (PDF)
Change Healthcare Outage Updates
- Change Healthcare Cybersecurity Incident and Its Impact to Meridian, MeridianComplete, Ambetter from Meridian, and Wellcare (Updated 2/27/2024)
- Availity Live Training Webinars
Medicaid and MMP - Additional Documentation
- National Kidney Foundation Change Package
- Affordable Connectivity Program Wind-Down (PDF)
- Payspan Resources
- Medical Records Compliance Reminder
- Home Help Agency Electronic Visit Verification Preparation:
Medicaid - Additional Documentation
- Electronic Medical Record Connectivity Initiative
- Speech Therapy Prior Authorization Updates - MDHHS Medicaid Provider Manual (PDF)
February 2024 - MI Monthly Provider Update (PDF)
Medicaid and MMP - Additional Documentation
- Evolent Musculoskeletal Management Program Memo (PDF)
- Evolent Musculoskeletal Management Program Webinar Schedule (PDF)
- Importal Dental Provider Change Notice
Medicaid - Additional Documentation
- Heart Health Awareness - Meridian's heart Health Coaching Program
- Speech Therapy Prior Authorization Updates - MDHHS Medicaid Provider Manual (PDF)
Additional Updates:
January 2024 - MI Monthly Provider Updates (PDF)
Medicaid & MMP - Additional Documentation
- Hybrid Heads Up - 2023 HEDIS hybrid project info
- Important Pharmacy Claims Processing Change - Express Scripts info
- RSV Vaccine Reminder
Medicaid - Additional Documentation
- MDHHS Bulletin - Healthy Michigan Plan Program Changes (PDF)
- MDHHS Bulletin - Nursing Facility Payment Amount Changes (PDF)
MMP - Additional Documentation
December 2023 - MI Monthly Provider Updates (PDF)
Medicaid & MMP - Additional Documentation
- Final Notice of Address Change - Billing and Payments Page
- Hybrid Heads Up - 2023 HEDIS hybrid project info
- Important Pharmacy Claims Processing Change - Express Scripts info
- Join the Fight Against the Flu: Encourage Vaccination for All Your Patients
Medicaid - Additional Documentation
- Time Sensitive Documentation Standards
- Chronic Kidney Disease Identification and Education (kidney.org)
- Michigan Medicaid Policy Update Awareness
- Change to Home Help Agency Provider Community Health Automated Medicaid Processing System (CHAMPS) Enrollment (MDHHS Policy MMP 23-64) (PDF)
MMP - Additional Documentation
Make sure to check Ongoing Reminders for important 2023 Bulletins you may have missed!
November 2023 - MI Monthly Provider Updates (PDF)
Medicaid & MMP - Additional Documentation
- Final Notice of Address Change - Billing and Payments Page
- Bronson Healthcare Announces New Agreement with Meridian
- Internal Self-Auditing - MDHHS Memo
- Hybrid Heads Up - 2023 HEDIS hybrid project info
- Important Pharmacy Claims Processing Change - Express Scripts info
- Join the Fight Against the Flu: Encourage Vaccination for All Your Patients
Medicaid - Additional Documentation
- Chronic Kidney Disease Identification and Education (kidney.org)
- Michigan Medicaid Policy Update Awareness
MMP - Additional Documentation
October 2023 - MI Monthly Provider Updates (PDF)
Medicaid & MMP - Additional Documentation
- Important Pharmacy Claims Processing Change, Effective January 1, 2024
- Complete Annual Cultural Competancy Training Information (PDF)
- New: Meridian MCS Claim System Retirement and Reminders on Timely Claim Filing Limits, Complaints and Disputes
- Provider Satisfaction Survey Information (PDF)
- Affordable Connectivity Program (PDF)
Meridian (Medicaid) Additional Documentation
September 2023 - MI Monthly Provider Updates (PDF)
MI Market updates
- New: Meridian MCS Claim System Retirement and Reminders on Timely Claim Filing Limits, Complaints and Disputes
- Provider Relations Intake Process and Survey
- Provider Satisfaction Survey Information (PDF)
- Affordable Connectivity Program (PDF)
Meridian (Medicaid) Updates
- Meridian Vision Eligibility Form Template (Microsoft Excel)
- Meridian (Medicaid) Clinical Practice Guidelines
MeridianComplete (MMP) Updates
August 2023 - MI Monthly Provider Updates (PDF)
July 2023 - MI Monthly Provider Updates (PDF)
- Appeal Cover Letter (PDF)
- PALS VRI Services Information (PDF)
- 2023 Meridian Z-Code Social Determinants of Health (SDoH) Incentive Program (PDF)
- Medical Transporation Management Non-Emergency Transporation Information (PDF)
- Monthly Provider Webinar Details (PDF)
- Demographic and Provider Practice Update Details (PDF)
- Pediatric Sickle Cell Disease Program Details (PDF)
- Hepatitis C Virus Program Details (PDF)
- Community Health Worker Information Flyer (PDF)
Ongoing Updates:
- Termination of Somatus Care Management Program for Patients with CKD/ESRD (PDF)
- Medicaid Redetermination Guidance (PDF)
Payment Policy Updates:
- Inappropriate Primary Diagnosis Denial Details (PDF)
- Optum CPI Overview (MMP) (PDF)
- Optum CPI Overview (Medicaid) (PDF)
- Claims Xten Optimization (MMP) (PDF)
June 2023 - MI Monthly Provider Updates (PDF)
- New Update: Termination of Somatus Care Management Program for Patients with CKD/ESRD (PDF)
- Affordable Connectivity Program (PDF)
- Medicaid Redetermination Guidance (PDF)
- Provider Language Assistance Tool (PDF)
New Payment Policy Updates:
- Inappropriate Primary Diagnosis Denial Details (PDF)
- Optum CPI Overview (MMP) (PDF)
- Optum CPI Overview (Medicaid) (PDF)
- Claims Xten Optimization (MMP) (PDF)
May 2023- MI Monthly Provider Updates (PDF)
- Prior Authorization Grace Period Changes (PDF)
- EX4U Denial Details (PDF)
- Chiropractor Prior Authorization Updates (PDF)
- End of COVID Auto Approval Notification (PDF)
April 2023- MI Monthly Provider Updates (PDF)
- Payspan Provider Webinars - May and June (PDF)
- Behavioral Health Online Training Details (PDF)
- Provider Workshop 2023 Details (PDF)
- Provider and Practice Demographic Updates (PDF)
- Anti-Kickback Statute Notification (PDF)
March Provider Update Newsletter (PDF)
- Inpatient Admissions Notification (PDF)
- Portal Claims Redesign (PDF)
- NEW UPDATE (3/10): Behavior Health Fee Schedule Notice (PDF)
- UPDATE: Chiropractic Claims Denial (PDF)
- MDHHS Provider Revalidation Alert (PDF)
- 2023 Provider Manual
- Pediatric Sickle Cell Disease Program (PDF)
- Hepatitis C Virus Program (PDF)
- NIA Webinars and Training Videos (PDS)