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News & Press: Insurance

Update on Medicaid Recoupment/Clawbacks

Thursday, November 14, 2019   (0 Comments)
Posted by: Algeria Wilson
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Thanks to your consistent feedback, NASW Michigan was able to advocate on your behalf to ensure that paybacks of Medicaid clawbacks were restored.  Many of you wrote, called and came to meetings to let us know the ways in which recoupment of Medicaid funds affected your clients as well as your business. One of our members, Tara Blurry was very instrumental in helping to articulate with legislators this issue facing social workers. Because your combined efforts MDHHS released the following information: 
Professional Providers: Claim adjustments fornon-physicians

Professional Providers,

Professional non-physician providers (Psychologists, Social workers, Marriage and Family Therapists, and Professional Counselors) with claim dates of service on or after 1/01/16, that were adjusted for recoupment per MSA15-44 and MSA16-14, will be reprocessed for repayment of recoupment.

MDHHS will adjust the impacted claims beginning on pay cycle date 10/10/2019 until complete. The claims can be identified with claim note “93103 repayment of recoupment”.

We realize that this is a short term solution, a small, yet mighty step towards what soon one day will be a long term solution. We also understand that many social workers are still facing billing and insurance issues. We encourage you to continue to share your clinical/insurance-related issues and concerns so that we may continue to advocate and solve these challenges. 
As always, please reach out to us with any clinical/insurance-related issues, concerns or more. Thank you for your membership!


Maxine Thome, Executive Director
Algeria Wilson, Director of Public Policy



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