09/11/2026

MDHHS Announces Standardized Credentialing and Plan Enrollment Process for Medicaid Health Plan Providers

The Michigan Department of Health and Human Services (MDHHS) is announcing upcoming changes to how individual providers will share information for credentialing and plan enrollment with Michigan’s Medicaid Health Plans (MHPs) beginning October 1, 2026.

When MDHHS launched its latest contract with MHPs in October 2024 it committed to standardizing the credentialing process to reduce administrative burden on providers and MHPs, enhance access to and quality of care, and improve oversight of Medicaid managed care.

Over the past two years, MDHHS met with leading state Medicaid agencies, MHPs, and providers to inform a standardized credentialing approach. Through stakeholder feedback, MDHHS identified plan enrollment requirements as an additional source of administrative burden for providers. As a result, the initiative was expanded to standardize both credentialing and plan enrollment processes.

What is Changing?

Providers that are currently credentialed and contracted with a health plan are not impacted by this change. Beginning October 1, 2026, providers seeking to join one or more MHP networks will submit a standardized set of information to MHPs, including:

• A credentialing application via the DataSpring Provider Data Portal (previously Council for Affordable Quality Healthcare [CAQH]); and
• A standardized plan enrollment packet developed by MHPs.

Providers will consult a forthcoming resource that indicates how to submit their information and who to contact at each MHP with questions about the credentialing and enrollment process.

Once information is submitted, MHPs will adhere to a standard set of timelines for application review and credentialing, including:

• 10 calendar days to validate that the information submitted by the provider is complete; if information is incomplete, the MHP must notify the provider.
• 60 calendar days to notify a provider of a final credentialing decision.
• 90 calendar days to determine whether to proceed with contracting; if proceeding with contracting, the MHP must also share a draft contract with the provider.

Note: Some MHPs and providers have established delegated credentialing processes, where an organization gives another entity the authority to perform some or all aspects of credentialing and recredentialing on its behalf. The standardized process does not apply to arrangements where the MHP has delegated credentialing to providers, provider systems, or associations. In existing circumstances where the MHP itself is acting as a Delegated Entity for credentialing that process may continue. MHPs must also accept Credentialing and Plan Enrollment applications from providers that seek to utilize the standardized process.

What This Means for Providers

For many providers, participating in multiple MHP networks has historically required navigating different requirements, processes, and forms and found it challenging to understand the status of the process with MHPs. Under the new approach, providers can expect:

• Greater consistency across MHPs, reducing the need to complete different forms for different MHPs.
• More predictable processing timelines and clearer communication regarding credentialing and contracting decisions.
• Easier access to information through centralized resources that identify MHP contacts and submission methods.

Preparing for October 1, 2026

MDHHS encourages providers interested in participating in MHP networks to:

• Maintain an up-to-date profile in the DataSpring Provider Data Portal (previously CAQH).
• Monitor communications from MDHHS and MHPs regarding implementation.
• Familiarize themselves with the new standardized enrollment packet and supporting documentation requirements once released.

Reminder: Recredentialing is not impacted by the changes starting in October.

MDHHS looks forward to continued partnership with stakeholders to implement this standard process. The standardized plan enrollment packet and supporting resources will be made available on or before October 1, 2026.