exv10w21w1



 





Exhibit 10.21.1




Form No. DMB 234 (Rev. 1/96)

AUTHORITY: Act 431 of 1984

COMPLETION: Required

PENALTY: Contract will not be executed unless form is filed



September 20, 2007


STATE OF MICHIGAN

DEPARTMENT OF MANAGEMENT AND BUDGET

PURCHASING OPERATIONS

P.O. BOX 30026, LANSING, MI 48909

OR

530 W. ALLEGAN, LANSING, MI 48933




CHANGE NOTICE NO. 12

TO

CONTRACT NO. 071B5200018

between

THE STATE OF MICHIGAN

and




	 	 	 	 	 	 	 
	 	 	 	 	 	 	 
	 	NAME & ADDRESS OF VENDOR  	 	TELEPHONE (248) 925-1710	 
	 	 

	 	 	 	Roman T. Kulich	 
	 	 	 	 	 	 	 
	 	     Molina Healthcare of Michigan Inc. 
     100 West Big Beaver Road, Suite 600 
      Troy, MI 48084	 	VENDOR NUMBER/MAIL CODE	 
	 	 	(2) 38-3341599 (004)	 
	 	 	 	 
	 	 

	 	 	 	BUYER/CA (517) 241-4225	 
	 	Roman.kulich@Molinahealthcare.com   	 	Kevin Dunn	 
	 	 	 
	 	Contract Compliance Inspector: Cheryl Bupp 241-7933	 	 	 
	 	     Comprehensive Health Care for Medicaid Beneficiaries — Regions 1, 4, 6, 7, 9, 10 — DCH	 
	 	 	 
	 	CONTRACT PERIOD:                                              From: October 1, 2004 
                                             To: September 30, 2008	 
	 	 	 	 	 	 	 
	 	TERMS	 	SHIPMENT	 
	 	N/A	 	N/A	 
	 	 	 	 	 	 	 
	 	F.O.B.	 	SHIPPED FROM	 
	 	N/A	 	N/A	 
	 	 	 	 	 	 	 
	 	MINIMUM DELIVERY REQUIREMENTS
	 	 	 	 	 
	 	N/A
	 	 	 	 	 
	 	 	 





NATURE OF CHANGE (S):





Effective October 1, 2007, the attached changes are incorporated into this Contract.
Furthermore, FY08 rates are included in the Contract. All other terms, conditions,
specifications, and pricing remain unchanged.



AUTHORITY/REASON:





Per DCH request and DMB/Purchasing Operations’ approval.



	 	 	 	 	 
	TOTAL ESTIMATED CONTRACT VALUE REMAINS:

	 	$667,875,969.33		 
	 
	 
	FOR THE VENDOR:

	 	FOR THE STATE:

	 
	Molina Healthcare of Michigan Inc.
	 	 	 	 
	 

	 	 	 	 
	Firm Name

	 	Signature

	 
	 

	 	Elise A. Lancaster

	 

	 	 	 	 
	Authorized Agent Signature

	 	Name

	 
	 

	 	Director, Purchasing Operations

	 

	 	 	 	 
	Authorized Agent (Print or Type)

	 	Title

	 
	 

	 	 	 	 
	Date

	 	Date







 









 






CHANGES FOR THE FY08 MEDICAID HEALTH PLAN CONTRACT




Effective Date 10/1/07




Contract Change #1 — Service Area Expansions



Modify section II-C (Targeted Geographical Area for Implementation of the CHCP) to clarify the
State’s policy with regard to the approval of requests for service area expansion. Specifically,
modify Section II-C-2 to clarify that approval of requests will be at the sole discretion of the
State.





DCH may consider Contractors’ requests for service area expansion during the term of the
Contract. Approval of service area expansion requests will be at the sole discretion of the
State. and will be contingent upon The state may consider certain factors including, but not limited to, the need for
additional capacity, Contractor performance, Contractor fiscal status, and Contractor provider
network. in the counties proposed under the expansion request. Requests should be submitted using the provider profile information form contained in
Appendix 1 of the Contract.



Rationale



This change clarifies that the State reserves the right to determine criteria upon which requests
for service area expansion are approved.




Contract Change #2 — Change in Mandatory Population



Modify Sections II-D-1, II-D-2, and II-H to reflect that pregnant women, whose pregnancy is the
basis for Medicaid eligibility, residing in rural exception counties, are changed from a voluntary
to mandatory population. Specifically, modify sections II-D-1 and II-D-2 as follows and add a new
section II-H-19.





	 	1.	 	Medicaid Eligible Groups Who Must Enroll in the CHCP:






	 	•	 	Families with children receiving assistance under the Financial Independence
Program (FIP)
	 
	 	•	 	Persons under age 21 who are receiving Medicaid
	 
	 	•	 	Persons receiving Medicaid for caretaker relatives and families with dependent
children who do
not receive FIP
	 
	 	•	 	Supplemental Security Income (SSI) Beneficiaries who do not receive Medicare
	 
	 	•	 	Persons receiving Medicaid for the blind or disabled
	 
	 	•	 	Persons receiving Medicaid for the aged
	 
	 	•	 	Pregnant women residing in a county listed in Appendix 6






	 	2.	 	Medicaid Eligible Groups Who May Voluntarily Enroll in the CHCP:






	 	•	 	Migrants
	 
	 	•	 	Native Americans
	 
	 	•	 	Pregnant women, whose pregnancy is the basis for Medicaid eligibility, who do
not reside in a county listed in Appendix 6





II-H-19. Pregnant Women



Special conditions apply to new mandatory Enrollees in the Contractor’s health plan whose Medicaid
eligibility was determined based on pregnancy. These Enrollees must be allowed to select or remain
with the Medicaid obstetrician of her choice and are entitled to receive all medically necessary
obstetrical and prenatal care without preauthorization from the health plan. In the event that the





1









 







Contractor does not have a contract with the provider, all claims should be paid at the Medicaid
fee-for-service rate.




Rationale



The single MHP operating in the Upper Peninsula counties through the rural exception waiver
maintains an extensive provider network. The network includes all Local Health Departments and the
overwhelming majority of obstetricians practicing in the Upper Peninsula. Therefore, pregnant women
in these counties may be made a mandatory population without impairment to continuity of care and
further will receive all of the benefits from managed care such as case management and ease of
transportation. The special coverage provisions are included to emphasize DCH requirements
regarding new mandatory-enrolled pregnant women.




Contract Change #3 — Special Disenrollments



Modify Section II-F-11 (a) (Disenrollment Requests Initiated by the Contractor, Special
Disenrollments) to clarify the circumstances under which Medicaid Health Plans can request a
disenrollment for enrollee noncompliance. Specifically, modify section II-F-1l (a) as follows:





	 	•	 	Other noncompliance situations involving the repeated use of non-Contractor providers when
in-network providers are available; discharge from the practices of available Contractor’s
network providers; repeated emergency room use for non-emergent services; and other situations
that impede care





Rationale



Based on the State’s review of noncompliance disenrollment requests submitted by the Medicaid
Health Plans, the State determined that the language regarding “failure to follow treatment plan”
may be broad and misleading. Several factors may impact an enrollee’s failure to follow a treatment
plan and a special disenrollment is not appropriate in all cases. Additionally, the State wishes to
clarify that repeated use of out-of-network providers is a rationale for special disenrollment only
in those cases where in-network providers are available.




Contract Change #4 — State and Federal False Claims Act



Add a new subsection to section II-I (Observance of Federal, State and Local Laws) to specifically
require Medicaid Health Plans (MHPs) to comply with all applicable portions of the State and
Federal False Claims Act. Specifically, the new Section II-I-9 shall read as follows:





	 	9.	 	Compliance with False Claims Acts






The Contractor shall comply with all applicable provisions of the Federal False Claims Act and
Michigan Medicaid False Claims Act. Actions taken to comply with the federal and state laws
specifically include, but are not limited to, the following:




	 	•	 	Establish and disseminate written policies for employees of the entity
(including
management) and any contractor or agent of the entity regarding the detection and

prevention of waste, fraud, and abuse.
	 
	 	•	 	The written policies must include detailed information about the False Claim Act
and
the other provisions named in section 1902(a)(68)(A).
	 
	 	•	 	The written policies must specify the rights of employees to be
protected as
whistleblowers.
	 
	 	•	 	The written policies must also be adopted by the Contractor’s contractors or
agents
A “contractor” or “agent” includes any contractor, subcontractor, agent, or other






2











 






person which or who, on behalf of the entity, furnishes, or otherwise
authorizes the furnishing of Medicaid health care items or services, performs
billing or coding functions, or is involved in monitoring of health care
provided by the entity. Contractors or agents that meet or surpass the
monetary threshold are subject to the requirements in this Section.




	 	•	 	If the Contractor currently has an employee handbook, the handbook must
contain the Contractor’s written policies for employees including an
explanation of the rights of employees to be protected as whistleblowers.





Rationale



Based on feedback from the Office of Inspector General and Centers for Medicare and Medicaid
Services, Michigan’s Medicaid False Claims Act does not include certain specific provisions
required under the Deficit Reduction Act. This contract change highlights these provisions and
ensures that the MHPs requirements are aligned with the key requirements under the federal law.




Contract Change #5 — Reporting Fraud and Abuse



Modify Section II-L-4 (Program Integrity) to more specifically define the requirements regarding
Contractor fraud and abuse reporting requirements. Specifically, modify this section as indicated:





	 	1.	 	Program Integrity
	 
	 	 	 	The Contractor must have administrative and management arrangements or procedures,
including a mandatory compliance plan. The Contractors’ arrangements or procedures must
include the following as defined in 42 CFR 438.608:






	 	•	 	Written policies and procedures that describes how the Contractor will comply
with federal and state fraud and abuse standards.
	 
	 	•	 	The designation of a compliance officer and a compliance committee who are
accountable to the senior management or Board of Directors and who have effective
lines of communication to the Contractor’s employees.
	 
	 	•	 	Effective training and education for the compliance officer and the Contractor’s
employees.
	 
	 	•	 	Provisions for internal monitoring and auditing.
	 
	 	•	 	Provisions for prompt response to detected offenses and for the development of
corrective action initiatives.
	 
	 	•	 	Documentation of the Contractor’s enforcement of the Federal and State fraud and
abuse standards.






Contractors who have any suspicion or knowledge of fraud and/or abuse within any of the
DCH’s programs must report directly to the DCH by calling (866) 428-0005 or sending a
memo or letter to:




Program Investigations Section

Capitol Commons Center Building

400 S. Pine Street, 6th floor

Lansing, Michigan 48909




The Contractor should must report all suspected fraud and/or abuse that warrant
investigation to the DCH, Program Investigation Section.



3









 






When reporting suspected fraud and/or abuse, Additionally, the Contractor shall provide the number of complaints that warrant a
preliminary investigation each year. Further, for each complaint that warrants full
investigation, the Contractor must provide to the DCH Program Investigation Section the
following information:




	 	•	 	The name of the provider, individuals, and/or entity involved in the suspected fraud and/or abuse,including their address,
phone number and Medicaid identification number, and any other identifying
information
	 
	 	•	 	Source of the complaint
	 
	 	•	 	Type of provider
	 
	 	•	 	Nature of the complaint
	 
	 	•	 	Approximate range of dollars involved
	 
	 	•	 	Legal and administrative disposition of the case, including actions taken by law
enforcement officials to whom the case has been referred.






The Contractor shall inform the DCH of actions taken to investigate or resolve the
reported suspicion, knowledge, or action. Contractors must also cooperate fully in any
investigation by the DCH or Office of Attorney General and any subsequent legal action
that may result from such investigation.




Contractors shall be permitted to disclose protected health information to DCH or the
Attorney General without first obtaining authorization from the enrollee to disclose
such information. DCH and the Attorney General shall ensure that such disclosures meet
the requirements for disclosures made as part of the Contractor’s treatment, payment, or
health care operations as defined in 45 CFR 164.501.



Rationale



The current contract does not include all the reporting components specified in the Balanced Budge
Act. The contract change is necessary to bring the contract into alignment with all specific
requirements of 42 CFR 455.17. All information required in this section remains an integral
component of the fraud and abuse site visits.




Contract Change #6 — Payment to Providers



Modify Section II-M (Payment to Providers) to incorporate language that enables MHPs to collaborate
with DCH and providers in the development and implementation of programs for improving access,
quality, and performance. Specifically, modify the introductory paragraph to read as follows:





The Contractor must make timely payments to all providers for covered services rendered to
enrollees as required by MCL 400.11li and in compliance with established DCH performance
standards (Appendix 4). Upon request from DCH, Contractors must develop programs for improving
access, quality, and performance with providers. Such programs must include DCH in the design
methodology, data collection, and evaluation. The Contractor must make all payments to both
network and out-of-network providers dictated by the methodology jointly developed by the
Contractor and DCH.



4









 






With the exception of newborns, the Contractor will not be responsible for any payments owed
to providers for services rendered prior to a beneficiary’s enrollment with the Contractor’s
plan. Except for newborns, payment for services provided during a period of retroactive
eligibility will be the responsibility of DCH.



Rationale



The intent of this contract change is to enable MHPs and DCH to work collaboratively to develop
innovative programs with health care providers. The contract language permits MHPs to make payments
to providers that participate in the programs designed to improve access, quality and performance.




Contract Change #7 — Clinical Practice Guidelines



Modify section II-O-I to clarify the time period required for provider assessment, feedback, and
review of clinical practice guidelines. Specifically, the 7th and 8th bullet
requirement for the written quality plan will be changed as follows:





	 	•	 	At least twice annually, provide performance feedback to providers, including detailed
discussion of clinical standards and expectations of the Contractor.
	 
	 	•	 	Develop, and/or adopt, and periodically review clinically appropriate practice parameters and
protocols/guidelines. Submit these parameters and protocols/guidelines to providers with
sufficient explanation and information to enable the providers to meet the established
standards.





Rationale



This contract change is designed to better align the contract provisions with the requirements
included as part of the on-site review process.




Contract Change #8 — Consumer Survey



Modify section II-O-6 to reflect the name change of the Consumer Assessment survey. Specifically,
the first sentence of section II-O-6 will be changed as follows:





Contractors must conduct an annual survey of their adult enrollee population using the
Consumer Assessment of Healthcare Providers and Systems Plan Survey (CAHPS®) instrument.



Rationale



The contract change is needed to accurately reflect the description of the CAHPS survey.




Contract Change #9 — Prevalent Language



Modify Section II-S (Enrollee Services) to clarify Contractor’s requirements regarding the
provision of interpretation services. Specifically, revise the fourth paragraph in Section II-S-3
to read as follows:





The handbook must be written at no higher than a 6.9 grade reading level and must be available
in alternative formats for enrollees with special needs. Member handbooks must be available in
a prevalent language when more than five percent (5%) of the Contractor’s enrollees speak a
prevalent language, as defined by the Contract. Contractors must also provide a mechanism for
enrollees who speak the prevalent language to obtain member materials in the prevalent
language and a mechanism for enrollees  or to obtain assistance with interpretation. The
Contractor must agree to make modifications in the handbook language so as to comply with the
specifications of this Contract.



5









 





Rationale



The current contract does not clearly delineate language requirements for written materials and
language requirements for oral interpretations services. The Balanced Budget Act Checklist provided
by the Center for Medicare and Medicaid Services emphasizes that managed care organizations must
make oral interpretation services available free of charge to all enrollees not just enrollees who
speak the prevalent non-English language.




Contract Change #10 — Provider Directory



Modify section II-S-2 to clarify that all Contractors are required to place the provider directory
on a web site available to the members. Prior to this contract change, placing the provider
directory on the Contractor’s web site was options. Specifically, modify the final bullet of
II-S-2(a) as follows:





	 	•	 	A website, maintained by the Contractor, that includes information on preventive
health strategies, health/wellness promotion programs offered by the Contractor, updates
related to covered services, access to providers, complete provider directory, and
updated policies and procedures.




Additionally, because placing the provider directory on the web site is no longer optional, the
following changes are needed in the final paragraph of II-S-3:





If
tThe Contractor must maintains a complete provider directory on the Contractor’s web site; the
Contractor is not required to a mail provider directory to all new enrollees. The web provider
directory must be reviewed for accuracy and updated at least monthly. The Contractor must
inform new enrollees that the provider directory is available upon request and on the
Contractor’s web site and must mail the provider directory within five business days of the
enrollee’s request



Rationale



Most MHPs have chosen to the place the provider directory on the web site. With the increasing
access to computers, providing access to the provider directory on the web site may improve access
to network providers and facilitate compliance with network limitations. Because the provider
directory will be available on the web site, MHPs are only required to mail the provider directory
to members upon request.




Contract Change #11 — Payment Withhold



Modify Section II-Z-1 (Contractor Performance Bonus) to reflect the revised withhold amount. DCH
has increased the threshold to .19%. The first sentence of this section will read as follows:





During
each Contract year, DCH will withhold .0012 .0019 of the approved capitation payment from
each Contractor until the performance bonus withhold reaches
approximately $35.0 million
dollars.



Rationale



In order to implement an increased performance bonus withhold of approximately $5.0 million, DCH
must increase the percentage of the capitation withhold amount.





6









 








Contract Change #12 — Appendix 6



Insert a new appendix at the end of the contract that lists the rural exception counties in which
pregnant women will be a mandatory population. Specifically, the newly inserted Appendix 6 will
read as follows:




Appendix 6

Rural Exception Counties in which Pregnant Women are a Mandatory Population




Alger

Baraga

Chippewa

Delta

Dickinson

Gogebic

Houghton

Iron

Keweenaw

Luce

Mackinac

Marquette

Menominee

Ontonagon

Schoolcraft




Rationale



The Centers for Medicare and Medicaid Services requested that the Department specifically lists the
counties in which pregnant women would be a mandatory population.





7









 








MEDICAID MANAGED CARE

PERFORMANCE MONITORING STANDARDS

(Contract Year October 1, 2007 — September 30, 2008)




Appendix 4 — PERFORMANCE MONITORING STANDARDS



PURPOSE: The purpose of the performance monitoring standards is to establish an explicit process
for the ongoing monitoring of health plan performance in important areas of quality, access,
customer services and reporting. The performance monitoring standards are part of the Contract
between the State of Michigan and Contracting Health Plans (Appendix 4).



The process is dynamic and reflects state and national issues that may change on a year-to-year
basis. Performance measurement is shared with Health Plans during the fiscal year and compares
performance of each Plan over time, to other health plans, and to industry standards, where
available.



The Performance Monitoring Standards address the following performance areas:





	 	•	 	Quality of Care
	 
	 	•	 	Access to Care
	 
	 	•	 	Customer Services
	 
	 	•	 	Claims Reporting and Processing
	 
	 	•	 	Encounter Data
	 
	 	•	 	Provider File reporting




For each performance area the following categories are identified:





	 	•	 	Measure
	 
	 	•	 	Goal
	 
	 	•	 	Minimum Standard for each measure
	 
	 	•	 	Data Source
	 
	 	•	 	Monitoring Intervals, (annually, quarterly, monthly)




Failure to meet the minimum performance monitoring standards may result in the implementation of
remedial actions and/or improvement plans as outlined in the contract section II-V.





 









 








	 	 	 	 	 	 	 	 	 	 	 
	PERFORMANCE AREA	 	GOAL	 	MINIMUM
 STANDARD	 	DATA SOURCE	 	MONITORING
INTERVALS
	•

	 	Quality of Care:


Childhood
Immunization
Status
	 	Fully immunize
children who turn
two years old
during the calendar
year.
	 	Combination 2

3
 82%
	 	HEDIS report
	 	Annual
	 
	 	 	 	 	 	 	 	 	 	 
	•

	 	Quality of Care:


Prenatal Care
	 	Pregnant women
receive an initial
prenatal care visit
in the first
trimester or within
42 days of
enrollment
	 	3
 85%
	 	MDCH Data Warehouse
	 	Quarterly
	 
	 	 	 	 	 	 	 	 	 	 
	•

	 	Quality of Care:


Postpartum Care
	 	Women delivering a
live birth received
a postpartum visit
on or between 21
days and 56 days
after delivery.
	 	3
 62%
	 	HEDIS report
	 	Annual
	 
	 	 	 	 	 	 	 	 	 	 
	•

	 	Quality of Care:


Blood Lead Testing
	 	Children at the age
of 3 years old
receive at least
one blood lead test
on/before
3rd
birthday
	 	3
 80% for total
enrollment and 3

80% for continuous
enrollment
	 	MDCH Data Warehouse
	 	Monthly
	 
	 	 	 	 	 	 	 	 	 	 
	•

	 	Access to care:


Well-Child Visits
in the First 15
Months of Life
	 	Children 15 months
of age receive six
or more well child
visits during first
15 months of life
	 	3
 60%
	 	Encounter data
	 	Quarterly
	 
	 	 	 	 	 	 	 	 	 	 
	•

	 	Access to care:


Well-Child Visits
in the Third,
Fourth, Fifth,
and Sixth Years
of Life
	 	Children three,
four, five, and six
years old receive
one or more well
child visits during
twelve-month
period.
	 	3
 68%
	 	Encounter data
	 	Quarterly






 









 






	 	 	 	 	 	 	 	 	 	 	 
	PERFORMANCE AREA	 	GOAL	 	MINIMUM
 STANDARD	 	DATA SOURCE	 	MONITORING
INTERVALS
	•

	 	Customer Services:


Enrollee Complaints
	 	Plan will have
minimal enrollee
contacts through
the Medicaid
Helpline for issues
determined to be
complaints
	 	Complaint rate <
..25 per 1000 member
months
	 	Beneficiary/Provider

contacts

tracking (BPCT)
	 	Quarterly
	 
	 	 	 	 	 	 	 	 	 	 
	•

	 	Claims Reporting
and Processing
	 	Health Plan submits
timely and complete
report, and
processes claims in
accordance with
minimum standard
	 	Timely, 3
 95% of
clean claims paid
within 30 days, and
£1.85%of ending
inventory over 45
days old
	 	Claims report

submitted by health

plan
	 	Monthly
	 
	 	 	 	 	 	 	 	 	 	 
	•

	 	Encounter Data

Reporting (Institutional,

Professional)
	 	Timely and complete
encounter data
submission by the
15th of the month
while meeting
minimum volume
requirements
	 	Timely and Complete
submission while
meeting minimum
volume
	 	MDCH Data Exchange
Gateway (DEG) and
MDCH Data Warehouse
	 	Monthly
	 
	 	 	 	 	 	 	 	 	 	 
	•

	 	Encounter Data

Reporting (Pharmacy)
	 	Timely and complete
encounter data
submission by the
15th of the month
while meeting
minimum volume
requirements
	 	Timely and Complete
submission while
meeting minimum
volume
	 	MDCH Data Exchange
Gateway (DEG) and
MDCH Data Warehouse
	 	Monthly
	 
	 	 	 	 	 	 	 	 	 	 
	•

	 	Provider File

Reporting
	 	Timely and accurate
provider file
update/submission
before the last
Tuesday of the
month
	 	Timely and Complete
submission
	 	Ml Enrolls
	 	Monthly





Minimum standard will be updated effective October 1, 2007 for HEDIS measures based on 2007 HEDIS
Michigan Medicaid Avg.





 











 





State of Michigan Managed Care Rates FY08

Effective October 1, 2007




Molina Healthcare 0004318627 0004318645; Counties 82




Region 01




	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	Phys	 	New	 	 	 	 	 	 	 	 	 	 	 	 	 	Adj	 	0.19%	 	Rate
	 	 	 	 	 	 	 	 	 	 	Base	 	Hosp	 	 	 	 	 	Access	 	Base	 	Area	 	Risk	 	OAA	 	Base	 	Bonus	 	after
	Rate Cell	 	Description	 	Sex	 	Rate	 	Adj	 	GME	 	Fee	 	Rate	 	Factor	 	Adj.	 	Factor	 	Rate	 	W/H	 	W/H
	 
	1
	 	TANF	 	< 1	 	 	 	M	 	 	356.82	 	 	 	112.83	 	 	 	39.18	 	 	 	3.38	 	 	 	512.21	 	 	 	0.996	 	 	 	 	 	 	 	 	 	 	 	510.16	 	 	 	-0.97	 	 	 	509.19	 
	2
	 	TANF	 	< 1	 	 	 	F	 	 	329.61	 	 	 	98.22	 	 	 	34.77	 	 	 	3.38	 	 	 	465.98	 	 	 	0.996	 	 	 	 	 	 	 	 	 	 	 	464.12	 	 	 	-0.88	 	 	 	463.24	 
	3
	 	TANF	 	1 - 4	 	 	 	M	 	 	85.16	 	 	 	15.43	 	 	 	2.33	 	 	 	3.38	 	 	 	106.3	 	 	 	0.996	 	 	 	 	 	 	 	 	 	 	 	105.87	 	 	 	-0.20	 	 	 	105.67	 
	4
	 	TANF	 	1 - 4	 	 	 	F	 	 	69.67	 	 	 	10.59	 	 	 	1.73	 	 	 	3.38	 	 	 	85.37	 	 	 	0.996	 	 	 	 	 	 	 	 	 	 	 	85.03	 	 	 	-0.16	 	 	 	84.87	 
	5
	 	TANF	 	5 - 14	 	 	 	M	 	 	54.51	 	 	 	7.12	 	 	 	0.96	 	 	 	3.38	 	 	 	65.97	 	 	 	0.996	 	 	 	 	 	 	 	 	 	 	 	65.71	 	 	 	-0.12	 	 	 	65.59	 
	6
	 	TANF	 	5 - 14	 	 	 	F	 	 	46.82	 	 	 	6.12	 	 	 	0.85	 	 	 	3.38	 	 	 	57.17	 	 	 	0.996	 	 	 	 	 	 	 	 	 	 	 	56.94	 	 	 	-0.11	 	 	 	56.83	 
	7
	 	TANF	 	15 - 20	 	 	 	M	 	 	56.48	 	 	 	10.11	 	 	 	1.76	 	 	 	3.38	 	 	 	71.73	 	 	 	0.996	 	 	 	 	 	 	 	 	 	 	 	71.44	 	 	 	-0.14	 	 	 	71.30	 
	8
	 	TANF	 	15 - 20	 	 	 	F	 	 	84.04	 	 	 	12.68	 	 	 	2.06	 	 	 	3.38	 	 	 	102.16	 	 	 	0.996	 	 	 	 	 	 	 	 	 	 	 	101.75	 	 	 	-0.19	 	 	 	101.56	 
	9
	 	TANF	 	21 - 25	 	 	 	M	 	 	94.10	 	 	 	21.43	 	 	 	3.69	 	 	 	3.38	 	 	 	122.6	 	 	 	0.996	 	 	 	 	 	 	 	 	 	 	 	122.11	 	 	 	-0.23	 	 	 	121.88	 
	10
	 	TANF	 	21 - 25	 	 	 	F	 	 	150.86	 	 	 	30.15	 	 	 	5.63	 	 	 	3.38	 	 	 	190.02	 	 	 	0.996	 	 	 	 	 	 	 	 	 	 	 	189.26	 	 	 	-0.36	 	 	 	188.90	 
	11
	 	TANF	 	26 - 44	 	 	 	M	 	 	213.46	 	 	 	45.38	 	 	 	10.83	 	 	 	3.38	 	 	 	273.05	 	 	 	0.996	 	 	 	 	 	 	 	 	 	 	 	271.96	 	 	 	-0.52	 	 	 	271.44	 
	12
	 	TANF	 	26 - 44	 	 	 	F	 	 	220.76	 	 	 	44.85	 	 	 	8.21	 	 	 	3.38	 	 	 	277.2	 	 	 	0.996	 	 	 	 	 	 	 	 	 	 	 	276.09	 	 	 	-0.52	 	 	 	275.57	 
	13
	 	TANF	 	45 +	 	 	 	M	 	 	407.57	 	 	 	82.90	 	 	 	21.09	 	 	 	3.38	 	 	 	514.94	 	 	 	0.996	 	 	 	 	 	 	 	 	 	 	 	512.88	 	 	 	-0.97	 	 	 	511.91	 
	14
	 	TANF	 	45 +	 	 	 	F	 	 	416.01	 	 	 	91.52	 	 	 	19.29	 	 	 	3.38	 	 	 	530.2	 	 	 	0.996	 	 	 	 	 	 	 	 	 	 	 	528.08	 	 	 	-1.00	 	 	 	527.08	 
	 
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	15
	 	ABAD	 	0 - 20	 	 	 	M	 	 	639.42	 	 	 	146.88	 	 	 	36.85	 	 	 	6.76	 	 	 	829.91	 	 	 	 	 	 	 	0.9200	 	 	 	 	 	 	 	763.52	 	 	 	-1.45	 	 	 	762.07	 
	16
	 	ABAD	 	0 - 20	 	 	 	F	 	 	639.42	 	 	 	146.88	 	 	 	36.85	 	 	 	6.76	 	 	 	829.91	 	 	 	 	 	 	 	0.9200	 	 	 	 	 	 	 	763.52	 	 	 	-1.45	 	 	 	762.07	 
	17.1
	 	ABAD	 	21 - 39	 	Medicare	 	M	 	 	639.42	 	 	 	146.88	 	 	 	36.85	 	 	 	6.76	 	 	 	829.91	 	 	 	 	 	 	 	0.9200	 	 	 	 	 	 	 	763.52	 	 	 	-1.45	 	 	 	762.07	 
	18.1
	 	ABAD	 	21 - 39	 	Medicare	 	F	 	 	639.42	 	 	 	146.88	 	 	 	36.85	 	 	 	6.76	 	 	 	829.91	 	 	 	 	 	 	 	0.9200	 	 	 	 	 	 	 	763.52	 	 	 	-1.45	 	 	 	762.07	 
	17.2
	 	ABAD	 	21 - 39	 	 	 	M	 	 	639.42	 	 	 	146.88	 	 	 	36.85	 	 	 	6.76	 	 	 	829.91	 	 	 	 	 	 	 	0.9200	 	 	 	 	 	 	 	763.52	 	 	 	-1.45	 	 	 	762.07	 
	18.2
	 	ABAD	 	21  - 39	 	 	 	F	 	 	639.42	 	 	 	146.88	 	 	 	36.85	 	 	 	6.76	 	 	 	829.91	 	 	 	 	 	 	 	0.9200	 	 	 	 	 	 	 	763.52	 	 	 	-1.45	 	 	 	762.07	 
	19.1
	 	ABAD	 	40 - 64	 	Medicare	 	M	 	 	639.42	 	 	 	146.88	 	 	 	36.85	 	 	 	6.76	 	 	 	829.91	 	 	 	 	 	 	 	0.9200	 	 	 	 	 	 	 	763.52	 	 	 	-1.45	 	 	 	762.07	 
	20.1
	 	ABAD	 	40 - 64	 	Medicare	 	F	 	 	639.42	 	 	 	146.88	 	 	 	36.85	 	 	 	6.76	 	 	 	829.91	 	 	 	 	 	 	 	0.9200	 	 	 	 	 	 	 	763.52	 	 	 	-1.45	 	 	 	762.07	 
	19.2
	 	ABAD	 	40 - 64	 	 	 	M	 	 	639.42	 	 	 	146.88	 	 	 	36.85	 	 	 	6.76	 	 	 	829.91	 	 	 	 	 	 	 	0.9200	 	 	 	 	 	 	 	763.52	 	 	 	-1.45	 	 	 	762.07	 
	20.2
	 	ABAD	 	40 - 64	 	 	 	F	 	 	639.42	 	 	 	146.88	 	 	 	36.85	 	 	 	6.76	 	 	 	829.91	 	 	 	 	 	 	 	0.9200	 	 	 	 	 	 	 	763.52	 	 	 	-1.45	 	 	 	762.07	 
	21.1
	 	ABAD	 	65 +	 	Medicare	 	M	 	 	639.42	 	 	 	146.88	 	 	 	36.85	 	 	 	6.76	 	 	 	829.91	 	 	 	 	 	 	 	0.9200	 	 	 	 	 	 	 	763.52	 	 	 	-1.45	 	 	 	762.07	 
	22.1
	 	ABAD	 	65 +	 	Medicare	 	F	 	 	639.42	 	 	 	146.88	 	 	 	36.85	 	 	 	6.76	 	 	 	829.91	 	 	 	 	 	 	 	0.9200	 	 	 	 	 	 	 	763.52	 	 	 	-1.45	 	 	 	762.07	 
	21.2
	 	ABAD	 	65 +	 	 	 	M	 	 	639.42	 	 	 	146.86	 	 	 	36.85	 	 	 	6.76	 	 	 	829.91	 	 	 	 	 	 	 	0.9200	 	 	 	 	 	 	 	763.52	 	 	 	-1.45	 	 	 	762.07	 
	22.2
	 	ABAD	 	65 +	 	 	 	F	 	 	639.42	 	 	 	146.88	 	 	 	36.85	 	 	 	6.76	 	 	 	829.91	 	 	 	 	 	 	 	0.9200	 	 	 	 	 	 	 	763.52	 	 	 	-1.45	 	 	 	762.07	 
	 
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	23.1
	 	OAA	 	0 +	 	Medicare	 	M	 	 	639.42	 	 	 	146.88	 	 	 	36.85	 	 	 	6.76	 	 	 	829.91	 	 	 	 	 	 	 	 	 	 	 	0.758	 	 	 	629.07	 	 	 	-1.20	 	 	 	627.87	 
	24.1
	 	OAA	 	0 +	 	Medicare	 	F	 	 	639.42	 	 	 	146.88	 	 	 	36.85	 	 	 	6.76	 	 	 	829.91	 	 	 	 	 	 	 	 	 	 	 	0.758	 	 	 	629.07	 	 	 	-1.20	 	 	 	627.87	 
	23.2
	 	OAA	 	0 +	 	 	 	M	 	 	639.42	 	 	 	146.88	 	 	 	36.85	 	 	 	6.76	 	 	 	829.91	 	 	 	 	 	 	 	 	 	 	 	0.758	 	 	 	629.07	 	 	 	-1.20	 	 	 	627.87	 
	24.2
	 	OAA	 	0 +	 	 	 	F	 	 	639.42	 	 	 	146.88	 	 	 	36.85	 	 	 	6.76	 	 	 	829.91	 	 	 	 	 	 	 	 	 	 	 	0.758	 	 	 	629.07	 	 	 	-1.20	 	 	 	627.87	 
	 
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	59.9	 	Rate MCR	 	 	 	 	4,529.56	 	 	 	1545.03	 	 	 	605.58	 	 	 	0.00	 	 	 	6680.17	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	6,680.17	 	 	 	-12.69	 	 	 	6667.00	 









			
	NOTE:	 	Due to MDCH Medicaid claims system limitations, MCR (Rate Cell 59.9) is rounded to nearest whole dollar after the bonus withhold.





Page 30









 










State of Michigan Managed Care Rates FY08

Effective October 1, 2007




Molina Healthcare 0004318627 0004318645; County 58




Region 02




	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	Phys	 	New	 	 	 	 	 	 	 	 	 	 	 	 	 	Adj	 	0.19%	 	Rate
	 	 	 	 	 	 	 	 	 	 	Base	 	Hosp	 	 	 	 	 	Access	 	Base	 	Area	 	Risk	 	OAA	 	Base	 	Bonus	 	after
	Rate Cell	 	Description	 	Sex	 	Rate	 	Adj	 	GME	 	Fee	 	Rate	 	Factor	 	Adj.	 	Factor	 	Rate	 	W/H	 	W/H
	 
	1
	 	TANF	 	< 1	 	 	 	M	 	 	342.76	 	 	 	99.34	 	 	 	35.21	 	 	 	3.38	 	 	 	480.69	 	 	 	1.029	 	 	 	 	 	 	 	 	 	 	 	494.63	 	 	 	-0.94	 	 	 	493.69	 
	2
	 	TANF	 	< 1	 	 	 	F	 	 	307.20	 	 	 	90.78	 	 	 	32.19	 	 	 	3.38	 	 	 	433.55	 	 	 	1.029	 	 	 	 	 	 	 	 	 	 	 	446.12	 	 	 	-0.85	 	 	 	445.27	 
	3
	 	TANF	 	1 - 4	 	 	 	M	 	 	81.05	 	 	 	14.58	 	 	 	2.12	 	 	 	3.38	 	 	 	101.13	 	 	 	1.029	 	 	 	 	 	 	 	 	 	 	 	104.06	 	 	 	-0.20	 	 	 	103.86	 
	4
	 	TANF	 	1 - 4	 	 	 	F	 	 	69.36	 	 	 	11.19	 	 	 	1.68	 	 	 	3.38	 	 	 	85.61	 	 	 	1.029	 	 	 	 	 	 	 	 	 	 	 	88.09	 	 	 	-0.17	 	 	 	87.92	 
	5
	 	TANF	 	5 - 14	 	 	 	M	 	 	64.56	 	 	 	7.76	 	 	 	1.00	 	 	 	3.38	 	 	 	76.7	 	 	 	1.029	 	 	 	 	 	 	 	 	 	 	 	78.92	 	 	 	-0.15	 	 	 	78.77	 
	6
	 	TANF	 	5 - 14	 	 	 	F	 	 	54.83	 	 	 	6.59	 	 	 	0.78	 	 	 	3.38	 	 	 	65.58	 	 	 	1.029	 	 	 	 	 	 	 	 	 	 	 	67.48	 	 	 	-0.13	 	 	 	67.35	 
	7
	 	TANF	 	15 - 20	 	 	 	M	 	 	68.86	 	 	 	11.50	 	 	 	1.83	 	 	 	3.38	 	 	 	85.57	 	 	 	1.029	 	 	 	 	 	 	 	 	 	 	 	88.05	 	 	 	-0.17	 	 	 	87.88	 
	8
	 	TANF	 	15 - 20	 	 	 	F	 	 	111.50	 	 	 	17.54	 	 	 	2.29	 	 	 	3.38	 	 	 	134.71	 	 	 	1.029	 	 	 	 	 	 	 	 	 	 	 	138.62	 	 	 	-0.26	 	 	 	138.36	 
	9
	 	TANF	 	21 - 25	 	 	 	M	 	 	101.22	 	 	 	20.74	 	 	 	3.15	 	 	 	3.38	 	 	 	128.49	 	 	 	1.029	 	 	 	 	 	 	 	 	 	 	 	132.22	 	 	 	-0.25	 	 	 	131.97	 
	10
	 	TANF	 	21 - 25	 	 	 	F	 	 	186.03	 	 	 	35.64	 	 	 	4.54	 	 	 	3.38	 	 	 	229.59	 	 	 	1.029	 	 	 	 	 	 	 	 	 	 	 	236.25	 	 	 	-0.45	 	 	 	235.80	 
	11
	 	TANF	 	26 - 44	 	 	 	M	 	 	230.29	 	 	 	56.57	 	 	 	7.86	 	 	 	3.38	 	 	 	298.1	 	 	 	1.029	 	 	 	 	 	 	 	 	 	 	 	306.74	 	 	 	-0.58	 	 	 	306.16	 
	12
	 	TANF	 	26 - 44	 	 	 	F	 	 	264.38	 	 	 	48.52	 	 	 	8.14	 	 	 	3.38	 	 	 	324.42	 	 	 	1.029	 	 	 	 	 	 	 	 	 	 	 	333.83	 	 	 	-0.63	 	 	 	333.20	 
	13
	 	TANF	 	45 +	 	 	 	M	 	 	429.31	 	 	 	83.78	 	 	 	19.59	 	 	 	3.38	 	 	 	536.06	 	 	 	1.029	 	 	 	 	 	 	 	 	 	 	 	551.61	 	 	 	-1.05	 	 	 	550.56	 
	14
	 	TANF	 	45 +	 	 	 	F	 	 	465.00	 	 	 	83.28	 	 	 	18.90	 	 	 	3.38	 	 	 	570.56	 	 	 	1.029	 	 	 	 	 	 	 	 	 	 	 	587.11	 	 	 	-1.12	 	 	 	585.99	 
	 
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	15
	 	ABAD	 	0 - 20	 	 	 	M	 	 	603.27	 	 	 	112.96	 	 	 	26.45	 	 	 	6.76	 	 	 	749.44	 	 	 	 	 	 	 	1.0020	 	 	 	 	 	 	 	750.94	 	 	 	-1.43	 	 	 	749.51	 
	16
	 	ABAD	 	0 - 20	 	 	 	F	 	 	603.27	 	 	 	112.96	 	 	 	26.45	 	 	 	6.76	 	 	 	749.44	 	 	 	 	 	 	 	1.0020	 	 	 	 	 	 	 	750.94	 	 	 	-1.43	 	 	 	749.51	 
	17.1
	 	ABAD	 	21 - 39	 	Medicare	 	M	 	 	603.27	 	 	 	112.96	 	 	 	26.45	 	 	 	6.76	 	 	 	749.44	 	 	 	 	 	 	 	1.0020	 	 	 	 	 	 	 	750.94	 	 	 	-1.43	 	 	 	749.51	 
	18.1
	 	ABAD	 	21 - 39	 	Medicare	 	F	 	 	603.27	 	 	 	112.96	 	 	 	26.45	 	 	 	6.76	 	 	 	749.44	 	 	 	 	 	 	 	1.0020	 	 	 	 	 	 	 	750.94	 	 	 	-1.43	 	 	 	749.51	 
	17.2
	 	ABAD	 	21 - 39	 	 	 	M	 	 	603.27	 	 	 	112.96	 	 	 	26.45	 	 	 	6.76	 	 	 	749.44	 	 	 	 	 	 	 	1.0020	 	 	 	 	 	 	 	750.94	 	 	 	-1.43	 	 	 	749.51	 
	18.2
	 	ABAD	 	21 - 39	 	 	 	F	 	 	603.27	 	 	 	112.96	 	 	 	26.45	 	 	 	6.76	 	 	 	749.44	 	 	 	 	 	 	 	1.0020	 	 	 	 	 	 	 	750.94	 	 	 	-1.43	 	 	 	749.51	 
	19.1
	 	ABAD	 	40 - 64	 	Medicare	 	M	 	 	603.27	 	 	 	112.96	 	 	 	26.45	 	 	 	6.76	 	 	 	749.44	 	 	 	 	 	 	 	1.0020	 	 	 	 	 	 	 	750.94	 	 	 	-1.43	 	 	 	749.51	 
	20.1
	 	ABAD	 	40 - 64	 	Medicare	 	F	 	 	603.27	 	 	 	112.96	 	 	 	26.45	 	 	 	6.76	 	 	 	749.44	 	 	 	 	 	 	 	1.0020	 	 	 	 	 	 	 	750.94	 	 	 	-1.43	 	 	 	749.51	 
	19.2
	 	ABAD	 	40 - 64	 	 	 	M	 	 	603.27	 	 	 	112.96	 	 	 	26.45	 	 	 	6.76	 	 	 	749.44	 	 	 	 	 	 	 	1.0020	 	 	 	 	 	 	 	750.94	 	 	 	-1.43	 	 	 	749.51	 
	20.2
	 	ABAD	 	40 - 64	 	 	 	F	 	 	603.27	 	 	 	112.96	 	 	 	26.45	 	 	 	6.76	 	 	 	749.44	 	 	 	 	 	 	 	1.0020	 	 	 	 	 	 	 	750.94	 	 	 	-1.43	 	 	 	749.51	 
	21.1
	 	ABAD	 	65 +	 	Medicare	 	M	 	 	603.27	 	 	 	112.96	 	 	 	26.45	 	 	 	6.76	 	 	 	749.44	 	 	 	 	 	 	 	1.0020	 	 	 	 	 	 	 	750.94	 	 	 	-1.43	 	 	 	749.51	 
	22.1
	 	ABAD	 	65 +	 	Medicare	 	F	 	 	603.27	 	 	 	112.96	 	 	 	26.45	 	 	 	6.76	 	 	 	749.44	 	 	 	 	 	 	 	1.0020	 	 	 	 	 	 	 	750.94	 	 	 	-1.43	 	 	 	749.51	 
	21.2
	 	ABAD	 	65 +	 	 	 	M	 	 	603.27	 	 	 	112.96	 	 	 	26.45	 	 	 	6.76	 	 	 	749.44	 	 	 	 	 	 	 	1.0020	 	 	 	 	 	 	 	750.94	 	 	 	-1.43	 	 	 	749.51	 
	22.2
	 	ABAD	 	65 +	 	 	 	F	 	 	603.27	 	 	 	112.96	 	 	 	26.45	 	 	 	6.76	 	 	 	749.44	 	 	 	 	 	 	 	1.0020	 	 	 	 	 	 	 	750.94	 	 	 	-1.43	 	 	 	749.51	 
	 
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	23.1
	 	OAA	 	0 +	 	Medicare	 	M	 	 	603.27	 	 	 	112.96	 	 	 	26.45	 	 	 	6.76	 	 	 	749.44	 	 	 	 	 	 	 	 	 	 	 	0.848	 	 	 	635.53	 	 	 	-1.21	 	 	 	634.32	 
	24.1
	 	OAA	 	0 +	 	Medicare	 	F	 	 	603.27	 	 	 	112.96	 	 	 	26.45	 	 	 	6.76	 	 	 	749.44	 	 	 	 	 	 	 	 	 	 	 	0.848	 	 	 	635.53	 	 	 	-1.21	 	 	 	634.32	 
	23.2
	 	OAA	 	0 +	 	 	 	M	 	 	603.27	 	 	 	112.96	 	 	 	26.45	 	 	 	6.76	 	 	 	749.44	 	 	 	 	 	 	 	 	 	 	 	0.848	 	 	 	635.53	 	 	 	-1.21	 	 	 	634.32	 
	24.2
	 	OAA	 	0 +	 	 	 	F	 	 	603.27	 	 	 	112.96	 	 	 	26.45	 	 	 	6.76	 	 	 	749.44	 	 	 	 	 	 	 	 	 	 	 	0.848	 	 	 	635.53	 	 	 	-1.21	 	 	 	634.32	 
	 
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	59.9	 	Rate MCR	 	 	 	 	4,246.33	 	 	 	1298.79	 	 	 	522.24	 	 	 	0.00	 	 	 	6067.36	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	6,067.36	 	 	 	-11.53	 	 	 	6056.00	 





			
	NOTE:	 	Due to MDCH Medicaid claims system limitations, MCR (Rate Cell 59.9) is rounded to nearest whole dollar after the bonus withhold.






Page 31









 






State of Michigan Managed Care Rates FY08

Effective October 1, 2007




Molina Healthcare 0004318627 0004318645; Counties 03, 10, 34, 41, 43, 51, 53, 54, 57, 59, 61, 62,
64, 67, 70, 83




Region 04




	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	Phys	 	New	 	 	 	 	 	 	 	 	 	 	 	 	 	Adj	 	0.19%	 	Rate
	 	 	 	 	 	 	 	 	 	 	Base	 	Hosp	 	 	 	 	 	Access	 	Base	 	Area	 	Risk	 	OAA	 	Base	 	Bonus	 	after
	Rate Cell	 	Description	 	Sex	 	Rate	 	Adj	 	GME	 	Fee	 	Rate	 	Factor	 	Adj.	 	Factor	 	Rate	 	W/H	 	W/H
	 
	1
	 	TANF	 	< 1	 	 	 	M	 	 	342.76	 	 	 	99.34	 	 	 	35.21	 	 	 	3.38	 	 	 	480.69	 	 	 	0.986	 	 	 	 	 	 	 	 	 	 	 	473.96	 	 	 	-0.90	 	 	 	473.06	 
	2
	 	TANF	 	< 1	 	 	 	F	 	 	307.20	 	 	 	90.78	 	 	 	32.19	 	 	 	3.38	 	 	 	433.55	 	 	 	0.986	 	 	 	 	 	 	 	 	 	 	 	427.48	 	 	 	-0.81	 	 	 	426.67	 
	3
	 	TANF	 	1 - 4	 	 	 	M	 	 	81.05	 	 	 	14.58	 	 	 	2.12	 	 	 	3.38	 	 	 	101.13	 	 	 	0.986	 	 	 	 	 	 	 	 	 	 	 	99.71	 	 	 	-0.19	 	 	 	99.52	 
	4
	 	TANF	 	1 - 4	 	 	 	F	 	 	69.36	 	 	 	11.19	 	 	 	1.68	 	 	 	3.38	 	 	 	85.61	 	 	 	0.986	 	 	 	 	 	 	 	 	 	 	 	84.41	 	 	 	-0.16	 	 	 	84.25	 
	5
	 	TANF	 	5 - 14	 	 	 	M	 	 	64.56	 	 	 	7.76	 	 	 	1.00	 	 	 	3.38	 	 	 	76.7	 	 	 	0.986	 	 	 	 	 	 	 	 	 	 	 	75.63	 	 	 	-0.14	 	 	 	75.49	 
	6
	 	TANF	 	5 - 14	 	 	 	F	 	 	54.83	 	 	 	6.59	 	 	 	0.78	 	 	 	3.38	 	 	 	65.58	 	 	 	0.986	 	 	 	 	 	 	 	 	 	 	 	64.66	 	 	 	-0.12	 	 	 	64.54	 
	7
	 	TANF	 	15 - 20	 	 	 	M	 	 	68.86	 	 	 	11.50	 	 	 	1.83	 	 	 	3.38	 	 	 	85.57	 	 	 	0.986	 	 	 	 	 	 	 	 	 	 	 	84.37	 	 	 	-0.16	 	 	 	84.21	 
	8
	 	TANF	 	15 - 20	 	 	 	F	 	 	111.50	 	 	 	17.54	 	 	 	2.29	 	 	 	3.38	 	 	 	134.71	 	 	 	0.986	 	 	 	 	 	 	 	 	 	 	 	132.82	 	 	 	-0.25	 	 	 	132.57	 
	9
	 	TANF	 	21 - 25	 	 	 	M	 	 	101.22	 	 	 	20.74	 	 	 	3.15	 	 	 	3.38	 	 	 	128.49	 	 	 	0.986	 	 	 	 	 	 	 	 	 	 	 	126.69	 	 	 	-0.24	 	 	 	126.45	 
	10
	 	TANF	 	21 - 25	 	 	 	F	 	 	186.03	 	 	 	35.64	 	 	 	4.54	 	 	 	3.38	 	 	 	229.59	 	 	 	0.986	 	 	 	 	 	 	 	 	 	 	 	226.38	 	 	 	-0.43	 	 	 	225.95	 
	11
	 	TANF	 	26 - 44	 	 	 	M	 	 	230.29	 	 	 	56.57	 	 	 	7.86	 	 	 	3.38	 	 	 	298.1	 	 	 	0.986	 	 	 	 	 	 	 	 	 	 	 	293.93	 	 	 	-0.56	 	 	 	293.37	 
	12
	 	TANF	 	26 - 44	 	 	 	F	 	 	264.38	 	 	 	48.52	 	 	 	8.14	 	 	 	3.38	 	 	 	324.42	 	 	 	0.986	 	 	 	 	 	 	 	 	 	 	 	319.88	 	 	 	-0.61	 	 	 	319.27	 
	13
	 	TANF	 	45+	 	 	 	M	 	 	429.31	 	 	 	83.78	 	 	 	19.59	 	 	 	3.38	 	 	 	536.06	 	 	 	0.986	 	 	 	 	 	 	 	 	 	 	 	528.56	 	 	 	-1.00	 	 	 	527.56	 
	14
	 	TANF	 	45+	 	 	 	F	 	 	465.00	 	 	 	83.28	 	 	 	18.90	 	 	 	3.38	 	 	 	570.56	 	 	 	0.986	 	 	 	 	 	 	 	 	 	 	 	562.57	 	 	 	-1.07	 	 	 	561.50	 
	 
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	15
	 	ABAD	 	0 - 20	 	 	 	M	 	 	603.27	 	 	 	112.96	 	 	 	26.45	 	 	 	6.76	 	 	 	749.44	 	 	 	 	 	 	 	0.9270	 	 	 	 	 	 	 	694.73	 	 	 	-1.32	 	 	 	693.41	 
	16
	 	ABAD	 	0 - 20	 	 	 	F	 	 	603.27	 	 	 	112.96	 	 	 	26.45	 	 	 	6.76	 	 	 	749.44	 	 	 	 	 	 	 	0.9270	 	 	 	 	 	 	 	694.73	 	 	 	-1.32	 	 	 	693.41	 
	17.1
	 	ABAD	 	21 - 39	 	Medicare	 	M	 	 	603.27	 	 	 	112.96	 	 	 	26.45	 	 	 	6.76	 	 	 	749.44	 	 	 	 	 	 	 	0.9270	 	 	 	 	 	 	 	694.73	 	 	 	-1.32	 	 	 	693.41	 
	18.1
	 	ABAD	 	21 - 39	 	Medicare	 	F	 	 	603.27	 	 	 	112.96	 	 	 	26.45	 	 	 	6.76	 	 	 	749.44	 	 	 	 	 	 	 	0.9270	 	 	 	 	 	 	 	694.73	 	 	 	-1.32	 	 	 	693.41	 
	17.2
	 	ABAD	 	21 - 39	 	 	 	M	 	 	603.27	 	 	 	112.96	 	 	 	26.45	 	 	 	6.76	 	 	 	749.44	 	 	 	 	 	 	 	0.9270	 	 	 	 	 	 	 	694.73	 	 	 	-1.32	 	 	 	693.41	 
	18.2
	 	ABAD	 	21 - 39	 	 	 	F	 	 	603.27	 	 	 	112.96	 	 	 	26.45	 	 	 	6.76	 	 	 	749.44	 	 	 	 	 	 	 	0.9270	 	 	 	 	 	 	 	694.73	 	 	 	-1.32	 	 	 	693.41	 
	19.1
	 	ABAD	 	40 - 64	 	Medicare	 	M	 	 	603.27	 	 	 	112.96	 	 	 	26.45	 	 	 	6.76	 	 	 	749.44	 	 	 	 	 	 	 	0.9270	 	 	 	 	 	 	 	694.73	 	 	 	-1.32	 	 	 	693.41	 
	20.1
	 	ABAD	 	40 - 64	 	Medicare	 	F	 	 	603.27	 	 	 	112.96	 	 	 	26.45	 	 	 	6.76	 	 	 	749.44	 	 	 	 	 	 	 	0.9270	 	 	 	 	 	 	 	694.73	 	 	 	-1.32	 	 	 	693.41	 
	19.2
	 	ABAD	 	40 - 64	 	 	 	M	 	 	603.27	 	 	 	112.96	 	 	 	26.45	 	 	 	6.76	 	 	 	749.44	 	 	 	 	 	 	 	0.9270	 	 	 	 	 	 	 	694.73	 	 	 	-1.32	 	 	 	693.41	 
	20.2
	 	ABAD	 	40 - 64	 	 	 	F	 	 	603.27	 	 	 	112.96	 	 	 	26.45	 	 	 	6.76	 	 	 	749.44	 	 	 	 	 	 	 	0.9270	 	 	 	 	 	 	 	694.73	 	 	 	-1.32	 	 	 	693.41	 
	21.1
	 	ABAD	 	65 +	 	Medicare	 	M	 	 	603.27	 	 	 	112.96	 	 	 	26.45	 	 	 	6.76	 	 	 	749.44	 	 	 	 	 	 	 	0.9270	 	 	 	 	 	 	 	694.73	 	 	 	-1.32	 	 	 	693.41	 
	22.1
	 	ABAD	 	65 +	 	Medicare	 	F	 	 	603.27	 	 	 	112.96	 	 	 	26.45	 	 	 	6.76	 	 	 	749.44	 	 	 	 	 	 	 	0.9270	 	 	 	 	 	 	 	694.73	 	 	 	-1.32	 	 	 	693.41	 
	21.2
	 	ABAD	 	65 +	 	 	 	M	 	 	603.27	 	 	 	112.96	 	 	 	26.45	 	 	 	6.76	 	 	 	749.44	 	 	 	 	 	 	 	0.9270	 	 	 	 	 	 	 	694.73	 	 	 	-1.32	 	 	 	693.41	 
	22.2
	 	ABAD	 	65 +	 	 	 	F	 	 	603.27	 	 	 	112.96	 	 	 	26.45	 	 	 	6.76	 	 	 	749.44	 	 	 	 	 	 	 	0.9270	 	 	 	 	 	 	 	694.73	 	 	 	-1.32	 	 	 	693.41	 
	 
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	23.1
	 	OAA	 	0 +	 	Medicare	 	M	 	 	603.27	 	 	 	112.96	 	 	 	26.45	 	 	 	6.76	 	 	 	749.44	 	 	 	 	 	 	 	 	 	 	 	0.848	 	 	 	635.53	 	 	 	-1.21	 	 	 	634.32	 
	24.1
	 	OAA	 	0 +	 	Medicare	 	F	 	 	603.27	 	 	 	112.96	 	 	 	26.45	 	 	 	6.76	 	 	 	749.44	 	 	 	 	 	 	 	 	 	 	 	0.848	 	 	 	635.53	 	 	 	-1.21	 	 	 	634.32	 
	23.2
	 	OAA	 	0 +	 	 	 	M	 	 	603.27	 	 	 	112.96	 	 	 	26.45	 	 	 	6.76	 	 	 	749.44	 	 	 	 	 	 	 	 	 	 	 	0.848	 	 	 	635.53	 	 	 	-1.21	 	 	 	634.32	 
	24.2
	 	OAA	 	0 +	 	 	 	F	 	 	603.27	 	 	 	112.96	 	 	 	26.45	 	 	 	6.76	 	 	 	749.44	 	 	 	 	 	 	 	 	 	 	 	0.848	 	 	 	635.53	 	 	 	-1.21	 	 	 	634.32	 
	 
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	59.9	 	Rate MCR	 	 	 	 	3,930.83	 	 	 	1298.79	 	 	 	522.24	 	 	 	0.00	 	 	 	5751.86	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	5,751.86	 	 	 	-10.93	 	 	 	5741.00	 








			
	NOTE:	 	Due to MDCH Medicaid claims system limitations, MCR (Rate Cell 59.9) is rounded to nearest whole dollar after the bonus withhold.







Page 32









 






State of Michigan Managed Care Rates FY08

Effective October 1, 2007




Molina Healthcare 0004318627 0004318645; County 25




Region 06




	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	Phys	 	New	 	 	 	 	 	 	 	 	 	 	 	 	 	Adj	 	0.19%	 	Rate
	 	 	 	 	 	 	 	 	 	 	Base	 	Hosp	 	 	 	 	 	Access	 	Base	 	Area	 	Risk	 	OAA	 	Base	 	Bonus	 	after
	Rate Cell	 	Description	 	Sex	 	Rate	 	Adj	 	GME	 	Fee	 	Rate	 	Factor	 	Adj.	 	Factor	 	Rate	 	W/H	 	W/H
	 
	1
	 	TANF	 	< 1	 	 	 	M	 	 	342.76	 	 	 	99.34	 	 	 	35.21	 	 	 	3.38	 	 	 	480.69	 	 	 	0.998	 	 	 	 	 	 	 	 	 	 	 	479.73	 	 	 	-0.91	 	 	 	478.82	 
	2
	 	TANF	 	< 1	 	 	 	F	 	 	307.20	 	 	 	90.78	 	 	 	32.19	 	 	 	3.38	 	 	 	433.55	 	 	 	0.998	 	 	 	 	 	 	 	 	 	 	 	432.68	 	 	 	-0.82	 	 	 	431.86	 
	3
	 	TANF	 	1 - 4	 	 	 	M	 	 	81.05	 	 	 	14.58	 	 	 	2.12	 	 	 	3.38	 	 	 	101.13	 	 	 	0.998	 	 	 	 	 	 	 	 	 	 	 	100.93	 	 	 	-0.19	 	 	 	100.74	 
	4
	 	TANF	 	1 - 4	 	 	 	F	 	 	69.36	 	 	 	11.19	 	 	 	1.68	 	 	 	3.38	 	 	 	85.61	 	 	 	0.998	 	 	 	 	 	 	 	 	 	 	 	85.44	 	 	 	-0.16	 	 	 	85.28	 
	5
	 	TANF	 	5 - 14	 	 	 	M	 	 	64.56	 	 	 	7.76	 	 	 	1.00	 	 	 	3.38	 	 	 	76.7	 	 	 	0.998	 	 	 	 	 	 	 	 	 	 	 	76.55	 	 	 	-0.15	 	 	 	76.40	 
	6
	 	TANF	 	5 - 14	 	 	 	F	 	 	54.83	 	 	 	6.59	 	 	 	0.78	 	 	 	3.38	 	 	 	65.58	 	 	 	0.998	 	 	 	 	 	 	 	 	 	 	 	65.45	 	 	 	-0.12	 	 	 	65.33	 
	7
	 	TANF	 	15 - 20	 	 	 	M	 	 	68.86	 	 	 	11.50	 	 	 	1.83	 	 	 	3.38	 	 	 	85.57	 	 	 	0.998	 	 	 	 	 	 	 	 	 	 	 	85.40	 	 	 	-0.16	 	 	 	85.24	 
	8
	 	TANF	 	15 - 20	 	 	 	F	 	 	111.50	 	 	 	17.54	 	 	 	2.29	 	 	 	3.38	 	 	 	134.71	 	 	 	0.998	 	 	 	 	 	 	 	 	 	 	 	134.44	 	 	 	-0.26	 	 	 	134.18	 
	9
	 	TANF	 	21 - 25	 	 	 	M	 	 	101.22	 	 	 	20.74	 	 	 	3.15	 	 	 	3.38	 	 	 	128.49	 	 	 	0.998	 	 	 	 	 	 	 	 	 	 	 	128.23	 	 	 	-0.24	 	 	 	127.99	 
	10
	 	TANF	 	21 - 25	 	 	 	F	 	 	186.03	 	 	 	35.64	 	 	 	4.54	 	 	 	3.38	 	 	 	229.59	 	 	 	0.998	 	 	 	 	 	 	 	 	 	 	 	229.13	 	 	 	-0.44	 	 	 	228.69	 
	11
	 	TANF	 	26 - 44	 	 	 	M	 	 	230.29	 	 	 	56.57	 	 	 	7.86	 	 	 	3.38	 	 	 	298.1	 	 	 	0.998	 	 	 	 	 	 	 	 	 	 	 	297.50	 	 	 	-0.57	 	 	 	296.93	 
	12
	 	TANF	 	26 - 44	 	 	 	F	 	 	264.38	 	 	 	48.52	 	 	 	8.14	 	 	 	3.38	 	 	 	324.42	 	 	 	0.998	 	 	 	 	 	 	 	 	 	 	 	323.77	 	 	 	-0.62	 	 	 	323.15	 
	13
	 	TANF	 	45 +	 	 	 	M	 	 	429.31	 	 	 	83.78	 	 	 	19.59	 	 	 	3.38	 	 	 	536.06	 	 	 	0.998	 	 	 	 	 	 	 	 	 	 	 	534.99	 	 	 	-1.02	 	 	 	533.97	 
	14
	 	TANF	 	45 +	 	 	 	F	 	 	465.00	 	 	 	83.28	 	 	 	18.90	 	 	 	3.38	 	 	 	570.56	 	 	 	0.998	 	 	 	 	 	 	 	 	 	 	 	569.42	 	 	 	-1.08	 	 	 	568.34	 
	 
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	15
	 	ABAD	 	0 - 20	 	 	 	M	 	 	603.27	 	 	 	112.96	 	 	 	26.45	 	 	 	6.76	 	 	 	749.44	 	 	 	 	 	 	 	1.0030	 	 	 	 	 	 	 	751.69	 	 	 	-1.43	 	 	 	750.26	 
	16
	 	ABAD	 	0 - 20	 	 	 	F	 	 	603.27	 	 	 	112.96	 	 	 	26.45	 	 	 	6.76	 	 	 	749.44	 	 	 	 	 	 	 	1.0030	 	 	 	 	 	 	 	751.69	 	 	 	-1.43	 	 	 	750.26	 
	17.1
	 	ABAD	 	21 - 39	 	Medicare	 	M	 	 	603.27	 	 	 	112.96	 	 	 	26.45	 	 	 	6.76	 	 	 	749.44	 	 	 	 	 	 	 	1.0030	 	 	 	 	 	 	 	751.69	 	 	 	-1.43	 	 	 	750.26	 
	18.1
	 	ABAD	 	21  - 39	 	Medicare	 	F	 	 	603.27	 	 	 	112.96	 	 	 	26.45	 	 	 	6.76	 	 	 	749.44	 	 	 	 	 	 	 	1.0030	 	 	 	 	 	 	 	751.69	 	 	 	-1.43	 	 	 	750.26	 
	17.2
	 	ABAD	 	21  - 39	 	 	 	M	 	 	603.27	 	 	 	112.96	 	 	 	26.45	 	 	 	6.76	 	 	 	749.44	 	 	 	 	 	 	 	1.0030	 	 	 	 	 	 	 	751.69	 	 	 	-1.43	 	 	 	750.26	 
	18.2
	 	ABAD	 	21  - 39	 	 	 	F	 	 	603.27	 	 	 	112.96	 	 	 	26.45	 	 	 	6.76	 	 	 	749.44	 	 	 	 	 	 	 	1.0030	 	 	 	 	 	 	 	751.69	 	 	 	-1.43	 	 	 	750.26	 
	19.1
	 	ABAD	 	40 - 64	 	Medicare	 	M	 	 	603.27	 	 	 	112.96	 	 	 	26.45	 	 	 	6.76	 	 	 	749.44	 	 	 	 	 	 	 	1.0030	 	 	 	 	 	 	 	751.69	 	 	 	-1.43	 	 	 	750.26	 
	20.1
	 	ABAD	 	40 - 64	 	Medicare	 	F	 	 	603.27	 	 	 	112.96	 	 	 	26.45	 	 	 	6.76	 	 	 	749.44	 	 	 	 	 	 	 	1.0030	 	 	 	 	 	 	 	751.69	 	 	 	-1.43	 	 	 	750.26	 
	19.2
	 	ABAD	 	40 - 64	 	 	 	M	 	 	603.27	 	 	 	112.96	 	 	 	26.45	 	 	 	6.76	 	 	 	749.44	 	 	 	 	 	 	 	1.0030	 	 	 	 	 	 	 	751.69	 	 	 	-1.43	 	 	 	750.26	 
	20.2
	 	ABAD	 	40 - 64	 	 	 	F	 	 	603.27	 	 	 	112.96	 	 	 	26.45	 	 	 	6.76	 	 	 	749.44	 	 	 	 	 	 	 	1.0030	 	 	 	 	 	 	 	751.69	 	 	 	-1.43	 	 	 	750.26	 
	21.1
	 	ABAD	 	65 +	 	Medicare	 	M	 	 	603.27	 	 	 	112.96	 	 	 	26.45	 	 	 	6.76	 	 	 	749.44	 	 	 	 	 	 	 	1.0030	 	 	 	 	 	 	 	751.69	 	 	 	-1.43	 	 	 	750.26	 
	22.1
	 	ABAD	 	65 +	 	Medicare	 	F	 	 	603.27	 	 	 	112.96	 	 	 	26.45	 	 	 	6.76	 	 	 	749.44	 	 	 	 	 	 	 	1.0030	 	 	 	 	 	 	 	751.69	 	 	 	-1.43	 	 	 	750.26	 
	21.2
	 	ABAD	 	65 +	 	 	 	M	 	 	603.27	 	 	 	112.96	 	 	 	26.45	 	 	 	6.76	 	 	 	749.44	 	 	 	 	 	 	 	1.0030	 	 	 	 	 	 	 	751.69	 	 	 	-1.43	 	 	 	750.26	 
	22.2
	 	ABAD	 	65 +	 	 	 	F	 	 	603.27	 	 	 	112.96	 	 	 	26.45	 	 	 	6.76	 	 	 	749.44	 	 	 	 	 	 	 	1.0030	 	 	 	 	 	 	 	751.69	 	 	 	-1.43	 	 	 	750.26	 
	 
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	23.1
	 	OAA	 	0 +	 	Medicare	 	M	 	 	603.27	 	 	 	112.96	 	 	 	26.45	 	 	 	6.76	 	 	 	749.44	 	 	 	 	 	 	 	 	 	 	 	0.848	 	 	 	635.53	 	 	 	-1.21	 	 	 	634.32	 
	24.1
	 	OAA	 	0 +	 	Medicare	 	F	 	 	603.27	 	 	 	112.96	 	 	 	26.45	 	 	 	6.76	 	 	 	749.44	 	 	 	 	 	 	 	 	 	 	 	0.848	 	 	 	635.53	 	 	 	-1.21	 	 	 	634.32	 
	23.2
	 	OAA	 	0 +	 	 	 	M	 	 	603.27	 	 	 	112.96	 	 	 	26.45	 	 	 	6.76	 	 	 	749.44	 	 	 	 	 	 	 	 	 	 	 	0.848	 	 	 	635.53	 	 	 	-1.21	 	 	 	634.32	 
	24.2
	 	OAA	 	0 +	 	 	 	F	 	 	603.27	 	 	 	112.96	 	 	 	26.45	 	 	 	6.76	 	 	 	749.44	 	 	 	 	 	 	 	 	 	 	 	0.848	 	 	 	635.53	 	 	 	-1.21	 	 	 	634.32	 
	 
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	59.9	 	Rate MCR	 	 	 	 	4,502.46	 	 	 	1298.79	 	 	 	522.24	 	 	 	0.00	 	 	 	6323.49	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	6,323.49	 	 	 	-12.01	 	 	 	6311.00	 






 
			
	NOTE:	 	Due to MDCH Medicaid claims system limitations, MCR (Rate Cell 59.9) is rounded to nearest whole dollar after the bonus withhold.





Page 33











 





State of Michigan Managed Care Rates FY08

Effective October 1, 2007



Molina Healthcare 0004318627 0004318645; Counties 01, 06, 09, 20, 26, 29, 32, 35, 37, 56, 60, 65,
68, 69, 71, 72, 73, 76, 79

Region 07




	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	Phys	 	 	New	 	 	 	 	 	 	 	 	 	 	 	 	 	 	Adj	 	 	0.19%	 	 	Rate	 
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	Access	 	 	Base	 	 	 	 	 	 	Risk	 	 	OAA	 	 	Base	 	 	Bonus	 	 	after	 
	Rate Cell	 	Description	 	Sex	 	Base Rate	 	 	Hosp Adj	 	 	GME	 	 	Fee	 	 	Rate	 	 	Area Factor	 	 	Adj.	 	 	Factor	 	 	Rate	 	 	W/H	 	 	W/H	 
	 
	1
	 	TANF	 	<1	 	 	 	M	 	 	342.76	 	 	 	99.34	 	 	 	35.21	 	 	 	3.38	 	 	 	480.69	 	 	 	1.009	 	 	 	 	 	 	 	 	 	 	 	485.02	 	 	 	-0.92	 	 	 	484.10	 
	2
	 	TANF	 	<1	 	 	 	F	 	 	307.20	 	 	 	90.78	 	 	 	32.19	 	 	 	3.38	 	 	 	433.55	 	 	 	1.009	 	 	 	 	 	 	 	 	 	 	 	437.45	 	 	 	-0.83	 	 	 	436.62	 
	3
	 	TANF	 	1-4	 	 	 	M	 	 	81.05	 	 	 	14.58	 	 	 	2.12	 	 	 	3.38	 	 	 	101.13	 	 	 	1.009	 	 	 	 	 	 	 	 	 	 	 	102.04	 	 	 	-0.19	 	 	 	101.85	 
	4
	 	TANF	 	1-4	 	 	 	F	 	 	69.36	 	 	 	11.19	 	 	 	1.68	 	 	 	3.38	 	 	 	85.61	 	 	 	1.009	 	 	 	 	 	 	 	 	 	 	 	86.38	 	 	 	-0.16	 	 	 	86.22	 
	5
	 	TANF	 	5-14	 	 	 	M	 	 	64.56	 	 	 	7.76	 	 	 	1.00	 	 	 	3.38	 	 	 	76.7	 	 	 	1.009	 	 	 	 	 	 	 	 	 	 	 	77.39	 	 	 	-0.15	 	 	 	77.24	 
	6
	 	TANF	 	5-14	 	 	 	F	 	 	54.83	 	 	 	6.59	 	 	 	0.78	 	 	 	3.38	 	 	 	65.58	 	 	 	1.009	 	 	 	 	 	 	 	 	 	 	 	66.17	 	 	 	-0.13	 	 	 	66.04	 
	7
	 	TANF	 	15-20	 	 	 	M	 	 	68.86	 	 	 	11.50	 	 	 	1.83	 	 	 	3.38	 	 	 	85.57	 	 	 	1.009	 	 	 	 	 	 	 	 	 	 	 	86.34	 	 	 	-0.16	 	 	 	86.18	 
	8
	 	TANF	 	15-20	 	 	 	F	 	 	111.50	 	 	 	17.54	 	 	 	2.29	 	 	 	3.38	 	 	 	134.71	 	 	 	1.009	 	 	 	 	 	 	 	 	 	 	 	135.92	 	 	 	-0.26	 	 	 	135.66	 
	9
	 	TANF	 	21-25	 	 	 	M	 	 	101.22	 	 	 	20.74	 	 	 	3.15	 	 	 	3.38	 	 	 	128.49	 	 	 	1.009	 	 	 	 	 	 	 	 	 	 	 	129.65	 	 	 	-0.25	 	 	 	129.40	 
	10
	 	TANF	 	21-25	 	 	 	F	 	 	186.03	 	 	 	35.64	 	 	 	4.54	 	 	 	3.38	 	 	 	229.59	 	 	 	1.009	 	 	 	 	 	 	 	 	 	 	 	231.66	 	 	 	-0.44	 	 	 	231.22	 
	11
	 	TANF	 	26-44	 	 	 	M	 	 	230.29	 	 	 	56.57	 	 	 	7.86	 	 	 	3.38	 	 	 	298.1	 	 	 	1.009	 	 	 	 	 	 	 	 	 	 	 	300.78	 	 	 	-0.57	 	 	 	300.21	 
	12
	 	TANF	 	26-44	 	 	 	F	 	 	264.38	 	 	 	48.52	 	 	 	8.14	 	 	 	3.38	 	 	 	324.42	 	 	 	1.009	 	 	 	 	 	 	 	 	 	 	 	327.34	 	 	 	-0.62	 	 	 	326.72	 
	13
	 	TANF	 	45 +	 	 	 	M	 	 	429.31	 	 	 	83.78	 	 	 	19.59	 	 	 	3.38	 	 	 	536.06	 	 	 	1.009	 	 	 	 	 	 	 	 	 	 	 	540.88	 	 	 	-1.03	 	 	 	539.85	 
	14
	 	TANF	 	45 +	 	 	 	F	 	 	465.00	 	 	 	83.28	 	 	 	18.90	 	 	 	3.38	 	 	 	570.56	 	 	 	1.009	 	 	 	 	 	 	 	 	 	 	 	575.70	 	 	 	-1.09	 	 	 	574.61	 
	 
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	15
	 	ABAD	 	0-20	 	 	 	M	 	 	603.27	 	 	 	112.96	 	 	 	26.45	 	 	 	6.76	 	 	 	749.44	 	 	 	 	 	 	 	0.9910	 	 	 	 	 	 	 	742.70	 	 	 	-1.41	 	 	 	741.29	 
	16
	 	ABAD	 	0-20	 	 	 	F	 	 	603.27	 	 	 	112.96	 	 	 	26.45	 	 	 	6.76	 	 	 	749.44	 	 	 	 	 	 	 	0.9910	 	 	 	 	 	 	 	742.70	 	 	 	-1.41	 	 	 	741.29	 
	17.1
	 	ABAD	 	21-39	 	Medicare	 	M	 	 	603.27	 	 	 	112.96	 	 	 	26.45	 	 	 	6.76	 	 	 	749.44	 	 	 	 	 	 	 	0.9910	 	 	 	 	 	 	 	742.70	 	 	 	-1.41	 	 	 	741.29	 
	18.1
	 	ABAD	 	21-39	 	Medicare	 	F	 	 	603.27	 	 	 	112.96	 	 	 	26.45	 	 	 	6.76	 	 	 	749.44	 	 	 	 	 	 	 	0.9910	 	 	 	 	 	 	 	742.70	 	 	 	-1.41	 	 	 	741.29	 
	17.2
	 	ABAD	 	21-39	 	 	 	M	 	 	603.27	 	 	 	112.96	 	 	 	26.45	 	 	 	6.76	 	 	 	749.44	 	 	 	 	 	 	 	0.9910	 	 	 	 	 	 	 	742.70	 	 	 	-1.41	 	 	 	741.29	 
	18.2
	 	ABAD	 	21-39	 	 	 	F	 	 	603.27	 	 	 	112.96	 	 	 	26.45	 	 	 	6.76	 	 	 	749.44	 	 	 	 	 	 	 	0.9910	 	 	 	 	 	 	 	742.70	 	 	 	-1.41	 	 	 	741.29	 
	19.1
	 	ABAD	 	40-64	 	Medicare	 	M	 	 	603.27	 	 	 	112.96	 	 	 	26.45	 	 	 	6.76	 	 	 	749.44	 	 	 	 	 	 	 	0.9910	 	 	 	 	 	 	 	742.70	 	 	 	-1.41	 	 	 	741.29	 
	20.1
	 	ABAD	 	40-64	 	Medicare	 	F	 	 	603.27	 	 	 	112.96	 	 	 	26.45	 	 	 	6.76	 	 	 	749.44	 	 	 	 	 	 	 	0.9910	 	 	 	 	 	 	 	742.70	 	 	 	-1.41	 	 	 	741.29	 
	19.2
	 	ABAD	 	40-64	 	 	 	M	 	 	603.27	 	 	 	112.96	 	 	 	26.45	 	 	 	6.76	 	 	 	749.44	 	 	 	 	 	 	 	0.9910	 	 	 	 	 	 	 	742.70	 	 	 	-1.41	 	 	 	741.29	 
	20.2
	 	ABAD	 	40-64	 	 	 	F	 	 	603.27	 	 	 	112.96	 	 	 	26.45	 	 	 	6.76	 	 	 	749.44	 	 	 	 	 	 	 	0.9910	 	 	 	 	 	 	 	742.70	 	 	 	-1.41	 	 	 	741.29	 
	21.1
	 	ABAD	 	65 +	 	Medicare	 	M	 	 	603.27	 	 	 	112.96	 	 	 	26.45	 	 	 	6.76	 	 	 	749.44	 	 	 	 	 	 	 	0.9910	 	 	 	 	 	 	 	742.70	 	 	 	-1.41	 	 	 	741.29	 
	22.1
	 	ABAD	 	65 +	 	Medicare	 	F	 	 	603.27	 	 	 	112.96	 	 	 	26.45	 	 	 	6.76	 	 	 	749.44	 	 	 	 	 	 	 	0.9910	 	 	 	 	 	 	 	742.70	 	 	 	-1.41	 	 	 	741.29	 
	21.2
	 	ABAD	 	65 +	 	 	 	M	 	 	603.27	 	 	 	112.96	 	 	 	26.45	 	 	 	6.76	 	 	 	749.44	 	 	 	 	 	 	 	0.9910	 	 	 	 	 	 	 	742.70	 	 	 	-1.41	 	 	 	741.29	 
	22.2
	 	ABAD	 	65 +	 	 	 	F	 	 	603.27	 	 	 	112.96	 	 	 	26.45	 	 	 	6.76	 	 	 	749.44	 	 	 	 	 	 	 	0.9910	 	 	 	 	 	 	 	742.70	 	 	 	-1.41	 	 	 	741.29	 
	 
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	23.1
	 	OAA	 	0 +	 	Medicare	 	M	 	 	603.27	 	 	 	112.96	 	 	 	26.45	 	 	 	6.76	 	 	 	749.44	 	 	 	 	 	 	 	 	 	 	 	0.848	 	 	 	635.53	 	 	 	-1.21	 	 	 	634.32	 
	24.1
	 	OAA	 	0 +	 	Medicare	 	F	 	 	603.27	 	 	 	112.96	 	 	 	26.45	 	 	 	6.76	 	 	 	749.44	 	 	 	 	 	 	 	 	 	 	 	0.848	 	 	 	635.53	 	 	 	-1.21	 	 	 	634.32	 
	23.2
	 	OAA	 	0 +	 	 	 	M	 	 	603.27	 	 	 	112.96	 	 	 	26.45	 	 	 	6.76	 	 	 	749.44	 	 	 	 	 	 	 	 	 	 	 	0.848	 	 	 	635.53	 	 	 	-1.21	 	 	 	634.32	 
	24.2
	 	OAA	 	0 +	 	 	 	F	 	 	603.27	 	 	 	112.96	 	 	 	26.45	 	 	 	6.76	 	 	 	749.44	 	 	 	 	 	 	 	 	 	 	 	0.848	 	 	 	635.53	 	 	 	-1.21	 	 	 	634.32	 
	 
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	59.9
	 	Rate MCR	 	 	 	 	 	 	 	 	4,190.98	 	 	 	1298.79	 	 	 	522.24	 	 	 	0.00	 	 	 	6012.01	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	6,012.01	 	 	 	-11.42	 	 	 	6001.00	 








			
	NOTE:  	 	Due to MDCH Medicaid claims system limitations, MCR (Rate
Cell 59.9) is rounded to nearest whole dollar after the bonus
withhold.





Page 34









 






State of Michigan Managed Care Rates FY08

Effective October 1, 2007




Molina Healthcare 0004318627 0004318645; Counties 50, 74

Region 09




	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	Phys	 	 	New	 	 	 	 	 	 	 	 	 	 	 	 	 	 	Adj	 	 	0.19%	 	 	Rate	 
	 	 	 	 	 	 	 	 	 	 	Base	 	 	Hosp	 	 	 	 	 	 	Access	 	 	Base	 	 	Area	 	 	Risk	 	 	OAA	 	 	Base	 	 	Bonus	 	 	after	 
	Rate Cell	 	Description	 	Sex	 	Rate	 	 	Adj	 	 	GME	 	 	Fee	 	 	Rate	 	 	Factor	 	 	Adj.	 	 	Factor	 	 	Rate	 	 	W/H	 	 	W/H	 
	 
	1
	 	TANF	 	<1	 	 	 	M	 	 	356.82	 	 	 	112.83	 	 	 	39.18	 	 	 	3.38	 	 	 	512.21	 	 	 	0.998	 	 	 	 	 	 	 	 	 	 	 	511.19	 	 	 	-0.97	 	 	 	510.22	 
	2
	 	TANF	 	<1	 	 	 	F	 	 	329.61	 	 	 	98.22	 	 	 	34.77	 	 	 	3.38	 	 	 	465.98	 	 	 	0.998	 	 	 	 	 	 	 	 	 	 	 	465.05	 	 	 	-0.88	 	 	 	464.17	 
	3
	 	TANF	 	1-4	 	 	 	M	 	 	85.16	 	 	 	15.43	 	 	 	2.33	 	 	 	3.38	 	 	 	106.3	 	 	 	0.998	 	 	 	 	 	 	 	 	 	 	 	106.09	 	 	 	-0.20	 	 	 	105.89	 
	4
	 	TANF	 	1-4	 	 	 	F	 	 	69.67	 	 	 	10.59	 	 	 	1.73	 	 	 	3.38	 	 	 	85.37	 	 	 	0.998	 	 	 	 	 	 	 	 	 	 	 	85.20	 	 	 	-0.16	 	 	 	85.04	 
	5
	 	TANF	 	5-14	 	 	 	M	 	 	54.51	 	 	 	7.12	 	 	 	0.96	 	 	 	3.38	 	 	 	65.97	 	 	 	0.998	 	 	 	 	 	 	 	 	 	 	 	65.84	 	 	 	-0.13	 	 	 	65.71	 
	6
	 	TANF	 	5-14	 	 	 	F	 	 	46.82	 	 	 	6.12	 	 	 	0.85	 	 	 	3.38	 	 	 	57.17	 	 	 	0.998	 	 	 	 	 	 	 	 	 	 	 	57.06	 	 	 	-0.11	 	 	 	56.95	 
	7
	 	TANF	 	15-20	 	 	 	M	 	 	56.48	 	 	 	10.11	 	 	 	1.76	 	 	 	3.38	 	 	 	71.73	 	 	 	0.998	 	 	 	 	 	 	 	 	 	 	 	71.59	 	 	 	-0.14	 	 	 	71.45	 
	8
	 	TANF	 	15-20	 	 	 	F	 	 	84.04	 	 	 	12.68	 	 	 	2.06	 	 	 	3.38	 	 	 	102.16	 	 	 	0.998	 	 	 	 	 	 	 	 	 	 	 	101.96	 	 	 	-0.19	 	 	 	101.77	 
	9
	 	TANF	 	21-25	 	 	 	M	 	 	94.10	 	 	 	21.43	 	 	 	3.69	 	 	 	3.38	 	 	 	122.6	 	 	 	0.998	 	 	 	 	 	 	 	 	 	 	 	122.35	 	 	 	-0.23	 	 	 	122.12	 
	10
	 	TANF	 	21-25	 	 	 	F	 	 	150.86	 	 	 	30.15	 	 	 	5.63	 	 	 	3.38	 	 	 	190.02	 	 	 	0.998	 	 	 	 	 	 	 	 	 	 	 	189.64	 	 	 	-0.36	 	 	 	189.28	 
	11
	 	TANF	 	26-44	 	 	 	M	 	 	213.46	 	 	 	45.38	 	 	 	10.83	 	 	 	3.38	 	 	 	273.05	 	 	 	0.998	 	 	 	 	 	 	 	 	 	 	 	272.50	 	 	 	-0.52	 	 	 	271.98	 
	12
	 	TANF	 	26-44	 	 	 	F	 	 	220.76	 	 	 	44.85	 	 	 	8.21	 	 	 	3.38	 	 	 	277.2	 	 	 	0.998	 	 	 	 	 	 	 	 	 	 	 	276.65	 	 	 	-0.53	 	 	 	276.12	 
	13
	 	TANF	 	45 +	 	 	 	M	 	 	407.57	 	 	 	82.90	 	 	 	21.09	 	 	 	3.38	 	 	 	514.94	 	 	 	0.998	 	 	 	 	 	 	 	 	 	 	 	513.91	 	 	 	-0.98	 	 	 	512.93	 
	14
	 	TANF	 	45 +	 	 	 	F	 	 	416.01	 	 	 	91.52	 	 	 	19.29	 	 	 	3.38	 	 	 	530.2	 	 	 	0.998	 	 	 	 	 	 	 	 	 	 	 	529.14	 	 	 	-1.01	 	 	 	528.13	 
	 
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	15
	 	ABAD	 	0-20	 	 	 	M	 	 	639.42	 	 	 	146.88	 	 	 	36.85	 	 	 	6.76	 	 	 	829.91	 	 	 	 	 	 	 	0.9920	 	 	 	 	 	 	 	823.27	 	 	 	-1.56	 	 	 	821.71	 
	16
	 	ABAD	 	0-20	 	 	 	F	 	 	639.42	 	 	 	146.88	 	 	 	36.85	 	 	 	6.76	 	 	 	829.91	 	 	 	 	 	 	 	0.9920	 	 	 	 	 	 	 	823.27	 	 	 	-1.56	 	 	 	821.71	 
	17.1
	 	ABAD	 	21-39	 	Medicare	 	M	 	 	639.42	 	 	 	146.88	 	 	 	36.85	 	 	 	6.76	 	 	 	829.91	 	 	 	 	 	 	 	0.9920	 	 	 	 	 	 	 	823.27	 	 	 	-1.56	 	 	 	821.71	 
	18.1
	 	ABAD	 	21-39	 	Medicare	 	F	 	 	639.42	 	 	 	146.88	 	 	 	36.85	 	 	 	6.76	 	 	 	829.91	 	 	 	 	 	 	 	0.9920	 	 	 	 	 	 	 	823.27	 	 	 	-1.56	 	 	 	821.71	 
	17.2
	 	ABAD	 	21-39	 	 	 	M	 	 	639.42	 	 	 	146.88	 	 	 	36.85	 	 	 	6.76	 	 	 	829.91	 	 	 	 	 	 	 	0.9920	 	 	 	 	 	 	 	823.27	 	 	 	-1.56	 	 	 	821.71	 
	18.2
	 	ABAD	 	21-39	 	 	 	F	 	 	639.42	 	 	 	146.88	 	 	 	36.85	 	 	 	6.76	 	 	 	829.91	 	 	 	 	 	 	 	0.9920	 	 	 	 	 	 	 	823.27	 	 	 	-1.56	 	 	 	821.71	 
	19.1
	 	ABAD	 	40-64	 	Medicare	 	M	 	 	639.42	 	 	 	146.88	 	 	 	36.85	 	 	 	6.76	 	 	 	829.91	 	 	 	 	 	 	 	0.9920	 	 	 	 	 	 	 	823.27	 	 	 	-1.56	 	 	 	821.71	 
	20.1
	 	ABAD	 	40-64	 	Medicare	 	F	 	 	639.42	 	 	 	146.88	 	 	 	36.85	 	 	 	6.76	 	 	 	829.91	 	 	 	 	 	 	 	0.9920	 	 	 	 	 	 	 	823.27	 	 	 	-1.56	 	 	 	821.71	 
	19.2
	 	ABAD	 	40-64	 	 	 	M	 	 	639.42	 	 	 	146.88	 	 	 	36.85	 	 	 	6.76	 	 	 	829.91	 	 	 	 	 	 	 	0.9920	 	 	 	 	 	 	 	823.27	 	 	 	-1.56	 	 	 	821.71	 
	20.2
	 	ABAD	 	40-64	 	 	 	F	 	 	639.42	 	 	 	146.88	 	 	 	36.85	 	 	 	6.76	 	 	 	829.91	 	 	 	 	 	 	 	0.9920	 	 	 	 	 	 	 	823,27	 	 	 	-1.56	 	 	 	821.71	 
	21.1
	 	ABAD	 	65 +	 	Medicare	 	M	 	 	639.42	 	 	 	146.88	 	 	 	36.85	 	 	 	6.76	 	 	 	829.91	 	 	 	 	 	 	 	0.9920	 	 	 	 	 	 	 	823.27	 	 	 	-1.56	 	 	 	821.71	 
	22.1
	 	ABAD	 	65 +	 	Medicare	 	F	 	 	639.42	 	 	 	146.88	 	 	 	36.85	 	 	 	6.76	 	 	 	829.91	 	 	 	 	 	 	 	0.9920	 	 	 	 	 	 	 	823.27	 	 	 	-1.56	 	 	 	821.71	 
	21.2
	 	ABAD	 	65 +	 	 	 	M	 	 	639.42	 	 	 	146.88	 	 	 	36.85	 	 	 	6.76	 	 	 	829.91	 	 	 	 	 	 	 	0.9920	 	 	 	 	 	 	 	823.27	 	 	 	-1.56	 	 	 	821.71	 
	22.2
	 	ABAD	 	65 +	 	 	 	F	 	 	639.42	 	 	 	146.88	 	 	 	36.85	 	 	 	6.76	 	 	 	829.91	 	 	 	 	 	 	 	0.9920	 	 	 	 	 	 	 	823.27	 	 	 	-1.56	 	 	 	821.71	 
	 
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	23.1
	 	OAA	 	0 +	 	Medicare	 	M	 	 	639.42	 	 	 	146.88	 	 	 	36.85	 	 	 	6.76	 	 	 	829.91	 	 	 	 	 	 	 	 	 	 	 	0.758	 	 	 	629.07	 	 	 	-1.20	 	 	 	627.87	 
	24.1
	 	OAA	 	0 +	 	Medicare	 	F	 	 	639.42	 	 	 	146.88	 	 	 	36.85	 	 	 	6.76	 	 	 	829.91	 	 	 	 	 	 	 	 	 	 	 	0.758	 	 	 	629.07	 	 	 	-1.20	 	 	 	627.87	 
	23.2
	 	OAA	 	0 +	 	 	 	M	 	 	639.42	 	 	 	146.88	 	 	 	36.85	 	 	 	6.76	 	 	 	829.91	 	 	 	 	 	 	 	 	 	 	 	0.758	 	 	 	629.07	 	 	 	-1.20	 	 	 	627.87	 
	24.2
	 	OAA	 	0 +	 	 	 	F	 	 	639.42	 	 	 	146.88	 	 	 	36.85	 	 	 	6.76	 	 	 	829.91	 	 	 	 	 	 	 	 	 	 	 	0.758	 	 	 	629.07	 	 	 	-1.20	 	 	 	627.87	 
	 
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	59.9
	 	Rate MCR	 	 	 	 	 	 	 	 	4,377.00	 	 	 	1545.03	 	 	 	605.58	 	 	 	0.00	 	 	 	6527.61	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	6,527.61	 	 	 	-12.40	 	 	 	6515.00	 







			
	NOTE:  	 	Due to MDCH Medicaid claims system limitations, MCR (Rate
Cell 59.9) is rounded to nearest whole dollar after the bonus
withhold.






Page 35









 






State of Michigan Managed Care Rates FY08

Effective October 1, 2007




Molina Healthcare 0004318627 0004318645; County 63

Region 10




	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	Phys	 	 	New	 	 	 	 	 	 	 	 	 	 	 	 	 	 	Adj	 	 	0.19%	 	 	Rate	 
	 	 	 	 	 	 	 	 	 	 	Base	 	 	Hosp	 	 	 	 	 	 	Access	 	 	Base	 	 	Area	 	 	Risk	 	 	OAA	 	 	Base	 	 	Bonus	 	 	after	 
	Rate Cell	 	Description	 	Sex	 	Rate	 	 	Adj	 	 	GME	 	 	Fee	 	 	Rate	 	 	Factor	 	 	Adj.	 	 	Factor	 	 	Rate	 	 	W/H	 	 	W/H	 
	 
	1
	 	TANF	 	<1	 	 	 	M	 	 	356.82	 	 	 	112.83	 	 	 	39.18	 	 	 	3.38	 	 	 	512.21	 	 	 	1.022	 	 	 	 	 	 	 	 	 	 	 	523.48	 	 	 	-0.99	 	 	 	522.49	 
	2
	 	TANF	 	<1	 	 	 	F	 	 	329.61	 	 	 	98.22	 	 	 	34.77	 	 	 	3.38	 	 	 	465.98	 	 	 	1.022	 	 	 	 	 	 	 	 	 	 	 	476.23	 	 	 	-0.90	 	 	 	475.33	 
	3
	 	TANF	 	1-4	 	 	 	M	 	 	85.16	 	 	 	15.43	 	 	 	2.33	 	 	 	3.38	 	 	 	106.3	 	 	 	1.022	 	 	 	 	 	 	 	 	 	 	 	108.64	 	 	 	-0.21	 	 	 	108.43	 
	4
	 	TANF	 	1-4	 	 	 	F	 	 	69.67	 	 	 	10.59	 	 	 	1.73	 	 	 	3.38	 	 	 	85.37	 	 	 	1.022	 	 	 	 	 	 	 	 	 	 	 	87.25	 	 	 	-0.17	 	 	 	87.08	 
	5
	 	TANF	 	5-14	 	 	 	M	 	 	54.51	 	 	 	7.12	 	 	 	0.96	 	 	 	3.38	 	 	 	65.97	 	 	 	1.022	 	 	 	 	 	 	 	 	 	 	 	67.42	 	 	 	-0.13	 	 	 	67.29	 
	6
	 	TANF	 	5-14	 	 	 	F	 	 	46.82	 	 	 	6.12	 	 	 	0.85	 	 	 	3.38	 	 	 	57.17	 	 	 	1.022	 	 	 	 	 	 	 	 	 	 	 	58.43	 	 	 	-0.11	 	 	 	58.32	 
	7
	 	TANF	 	15-20	 	 	 	M	 	 	56.48	 	 	 	10.11	 	 	 	1.76	 	 	 	3.38	 	 	 	71.73	 	 	 	1.022	 	 	 	 	 	 	 	 	 	 	 	73.31	 	 	 	-0.14	 	 	 	73.17	 
	8
	 	TANF	 	15-20	 	 	 	F	 	 	84.04	 	 	 	12.68	 	 	 	2.06	 	 	 	3.38	 	 	 	102.16	 	 	 	1.022	 	 	 	 	 	 	 	 	 	 	 	104.41	 	 	 	-0.20	 	 	 	104.21	 
	9
	 	TANF	 	21-25	 	 	 	M	 	 	94.10	 	 	 	21.43	 	 	 	3.69	 	 	 	3.38	 	 	 	122.6	 	 	 	1.022	 	 	 	 	 	 	 	 	 	 	 	125.30	 	 	 	-0.24	 	 	 	125.06	 
	10
	 	TANF	 	21-25	 	 	 	F	 	 	150.86	 	 	 	30.15	 	 	 	5.63	 	 	 	3.38	 	 	 	190.02	 	 	 	1.022	 	 	 	 	 	 	 	 	 	 	 	194.20	 	 	 	-0.37	 	 	 	193.83	 
	11
	 	TANF	 	26-44	 	 	 	M	 	 	213.46	 	 	 	45.38	 	 	 	10.83	 	 	 	3.38	 	 	 	273.05	 	 	 	1.022	 	 	 	 	 	 	 	 	 	 	 	279.06	 	 	 	-0.53	 	 	 	278.53	 
	12
	 	TANF	 	26-44	 	 	 	F	 	 	220.76	 	 	 	44.85	 	 	 	8.21	 	 	 	3.38	 	 	 	277.2	 	 	 	1.022	 	 	 	 	 	 	 	 	 	 	 	283.30	 	 	 	-0.54	 	 	 	282.76	 
	13
	 	TANF	 	45 +	 	 	 	M	 	 	407.57	 	 	 	82.90	 	 	 	21.09	 	 	 	3.38	 	 	 	514.94	 	 	 	1.022	 	 	 	 	 	 	 	 	 	 	 	526.27	 	 	 	-1.00	 	 	 	525.27	 
	14
	 	TANF	 	45 +	 	 	 	F	 	 	416.01	 	 	 	91.52	 	 	 	19.29	 	 	 	3.38	 	 	 	530.2	 	 	 	1.022	 	 	 	 	 	 	 	 	 	 	 	541.86	 	 	 	-1.03	 	 	 	540.83	 
	 
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	15
	 	ABAD	 	0-20	 	 	 	M	 	 	639.42	 	 	 	146.88	 	 	 	36.85	 	 	 	6.76	 	 	 	829.91	 	 	 	 	 	 	 	0.9870	 	 	 	 	 	 	 	819.12	 	 	 	-1.56	 	 	 	817.56	 
	16
	 	ABAD	 	0-20	 	 	 	F	 	 	639.42	 	 	 	146.88	 	 	 	36.85	 	 	 	6.76	 	 	 	829.91	 	 	 	 	 	 	 	0.9870	 	 	 	 	 	 	 	819.12	 	 	 	-1.56	 	 	 	817.56	 
	17.1
	 	ABAD	 	21-39	 	Medicare	 	M	 	 	639.42	 	 	 	146.88	 	 	 	36.85	 	 	 	6.76	 	 	 	829.91	 	 	 	 	 	 	 	0.9870	 	 	 	 	 	 	 	819.12	 	 	 	-1.56	 	 	 	817.56	 
	18.1
	 	ABAD	 	21-39	 	Medicare	 	F	 	 	639.42	 	 	 	146.88	 	 	 	36.85	 	 	 	6.76	 	 	 	829.91	 	 	 	 	 	 	 	0.9870	 	 	 	 	 	 	 	819.12	 	 	 	-1.56	 	 	 	817.56	 
	17.2
	 	ABAD	 	21-39	 	 	 	M	 	 	639.42	 	 	 	146.88	 	 	 	36.85	 	 	 	6.76	 	 	 	829.91	 	 	 	 	 	 	 	0.9870	 	 	 	 	 	 	 	819.12	 	 	 	-1.56	 	 	 	817.56	 
	18.2
	 	ABAD	 	21-39	 	 	 	F	 	 	639.42	 	 	 	146.88	 	 	 	36.85	 	 	 	6.76	 	 	 	829.91	 	 	 	 	 	 	 	0.9870	 	 	 	 	 	 	 	819.12	 	 	 	-1.56	 	 	 	817.56	 
	19.1
	 	ABAD	 	40-64	 	Medicare	 	M	 	 	639.42	 	 	 	146.88	 	 	 	36.85	 	 	 	6.76	 	 	 	829.91	 	 	 	 	 	 	 	0.9870	 	 	 	 	 	 	 	819.12	 	 	 	-1.56	 	 	 	817.56	 
	20.1
	 	ABAD	 	40-64	 	Medicare	 	F	 	 	639.42	 	 	 	146.88	 	 	 	36.85	 	 	 	6.76	 	 	 	829.91	 	 	 	 	 	 	 	0.9870	 	 	 	 	 	 	 	819.12	 	 	 	-1.56	 	 	 	817.56	 
	19.2
	 	ABAD	 	40-64	 	 	 	M	 	 	639.42	 	 	 	146.88	 	 	 	36.85	 	 	 	6.76	 	 	 	829.91	 	 	 	 	 	 	 	0.9870	 	 	 	 	 	 	 	819.12	 	 	 	-1.56	 	 	 	817.56	 
	20.2
	 	ABAD	 	40-64	 	 	 	F	 	 	639.42	 	 	 	146.88	 	 	 	36.85	 	 	 	6.76	 	 	 	829.91	 	 	 	 	 	 	 	0.9870	 	 	 	 	 	 	 	819.12	 	 	 	-1.56	 	 	 	817.56	 
	21.1
	 	ABAD	 	65 +	 	Medicare	 	M	 	 	639.42	 	 	 	146.88	 	 	 	36.85	 	 	 	6.76	 	 	 	829.91	 	 	 	 	 	 	 	0.9870	 	 	 	 	 	 	 	819.12	 	 	 	-1.56	 	 	 	817.56	 
	22.1
	 	ABAD	 	65 +	 	Medicare	 	F	 	 	639.42	 	 	 	146.88	 	 	 	36.85	 	 	 	6.76	 	 	 	829.91	 	 	 	 	 	 	 	0.9870	 	 	 	 	 	 	 	819.12	 	 	 	-1.56	 	 	 	817.56	 
	21.2
	 	ABAD	 	65 +	 	 	 	M	 	 	639.42	 	 	 	146.88	 	 	 	36.85	 	 	 	6.76	 	 	 	829.91	 	 	 	 	 	 	 	0.9870	 	 	 	 	 	 	 	819.12	 	 	 	-1.56	 	 	 	817.56	 
	22.2
	 	ABAD	 	65 +	 	 	 	F	 	 	639.42	 	 	 	146.88	 	 	 	36.85	 	 	 	6.76	 	 	 	829.91	 	 	 	 	 	 	 	0.9870	 	 	 	 	 	 	 	819.12	 	 	 	-1.56	 	 	 	817.56	 
	 
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	23.1
	 	OAA	 	0 +	 	Medicare	 	M	 	 	639.42	 	 	 	146.88	 	 	 	36.85	 	 	 	6.76	 	 	 	829.91	 	 	 	 	 	 	 	 	 	 	 	0.758	 	 	 	629.07	 	 	 	-1.20	 	 	 	627.87	 
	24.1
	 	OAA	 	0 +	 	Medicare	 	F	 	 	639.42	 	 	 	146.88	 	 	 	36.85	 	 	 	6.76	 	 	 	829.91	 	 	 	 	 	 	 	 	 	 	 	0.758	 	 	 	629.07	 	 	 	-1.20	 	 	 	627.87	 
	23.2
	 	OAA	 	0 +	 	 	 	M	 	 	639.42	 	 	 	146.88	 	 	 	36.85	 	 	 	6.76	 	 	 	829.91	 	 	 	 	 	 	 	 	 	 	 	0.758	 	 	 	629.07	 	 	 	-1.20	 	 	 	627.87	 
	24.2
	 	OAA	 	0 +	 	 	 	F	 	 	639.42	 	 	 	146.88	 	 	 	36.85	 	 	 	6.76	 	 	 	829.91	 	 	 	 	 	 	 	 	 	 	 	0.758	 	 	 	629.07	 	 	 	-1.20	 	 	 	627.87	 
	 
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	59.9
	 	Rate MCR	 	 	 	 	 	 	 	 	4,512.89	 	 	 	1545.03	 	 	 	605.58	 	 	 	0.00	 	 	 	6663.5	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	6,663.50	 	 	 	-12.66	 	 	 	6651.00	 







			
	NOTE:  	 	Due to MDCH Medicaid claims system limitations, MCR (Rate
Cell 59.9) is rounded to nearest whole dollar after the bonus
withhold.






Page 36