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Alert: Michigan Medicaid improper payment / claims denied in error

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Abigail Nobel
(@mhf)
Member Admin
Joined: 5 years ago
Posts: 1226
Topic starter  

MDHHS alerted providers to a breaking problem today. The email subject line was, "Claim Type Denials in Error."

Attention all providers,

MDHHS has been made aware of claims denied in error with Claim Adjustment Reason Code (CARC) 16 and Remittance Advice Remark Code (RARC) MA30.

MDHHS is still reviewing the full impact and will post a new alert with additional details as they become available.

Providers with additional questions should contact Provider Support at 1-800-292-2550 or by email at ProviderSupport@Michigan.gov .

Improper payment rates were hotly contested during OBBBA passage earlier this year, with the Left generally denying the high numbers stated by the Trump Administration.



   
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Abigail Nobel
(@mhf)
Member Admin
Joined: 5 years ago
Posts: 1226
Topic starter  

MDHHS buried the lede.

Mackinac Center published the real story, beating MDHHS by one day.

https://www.michigancapitolconfidential.com/news/michigan-health-employee-approved-denied-benefits-without-interviews

Michigan health employee approved, denied benefits without interviews

Employee fired for repeatedly falsifying records, delaying benefits

A state of Michigan employee ghosted low-income residents, falsified documents multiple times, and approved and denied benefits without interviews. Still, it took the state years to fire him, according to a months-long investigation by Michigan Capitol Confidential.

Ashanta Butler worked for the state of Michigan’s health department for 23 years before he was fired for not doing his job, according to hundreds of pages of documents CapCon obtained through a records request.

For years, Michigan’s payment error rate for welfare benefits — how often it inaccurately awards them — has fluctuated. In fiscal year 2022, it was 13%. The next year, it dropped to 10%, and this year it’s 9.53%.

“After several complaints from clients were received, a review of Mr. Butler’s cases revealed that he was not completing scheduled interviews prior to approving or denying benefits,” the terminal letter read. “Of the 17 cases read, 7 cases were certified without completing and/or documenting an interview, 4 cases documented an interview but there were no calls to/from the client on the dates documented. In 11 cases, he failed to call the clients on their scheduled interview date/time resulting in them being marked ‘no show’ in Bridges. 3 cases were processed with no IG and 4 cases were processed with other errors.”

When confronted, he alleged a coverup, sending an email to three state employees: Elizabeth Hertel, director of the Department of Health and Human Services; Dwayne Haywood, a senior deputy director within that department; and LaRhonda Stallings, a human resources specialist in the Michigan Civil Service Commission.

“I was constantly directed to re-instate this case although this client never cooperated with policy and procedure,” Butler wrote.

He also wrote that he explained to investigators that “not even Jesus himself or a natural” disaster could close the case. “The client always had a direct line to management,” he wrote, “to top off others involved in the aiding and abetting.”

Butler wrote that the person had help from within the department.

“I was totally blown away when the Union Steward that has represented me on that could have exonerated me from these allegations tells you that this client definitely had help to defraud the state of Michigan.”

Taylor Jenkins, another state health department worker, wrote in an Oct. 3, 2023, email to Butler that was investigating fraud committed by state employees,

“Client also states he is paralyzed form (sic) a car accident. Client does not have an authorized representative on his case but he continues to have someone else pick up paperwork(.) (A)ccording to client he is receiving no income form the car accident or insurance company(.) (P)lease verify if client is receiving any income from car accident. FYI i received emails from an unidentified person in regards to this client case. Not sure (who) she is and why she is handling all (redacted) affairs.”

CapCon paid $335 and received the documents.

Butler appears to have been rightfully fired, according to hundreds of documents reviewed by CapCon. Another state health department employee reviewed the documents and agreed. This employee, who holds the same job classification that Butler held, asked to remain anonymous for fear of retribution.

Ltr - Butler Dismissal Macomb Apr 2024 R by mcclallen

The documents claimed that Butler’s errors hurt Michiganders who received the benefits late or in the wrong amount. Michigan must repay the federal government $415 million because the state’s largest agency struggles to give benefits accurately, CapCon reported.

“At least 4 of the clients reviewed suffered a delay of up to 2 months in receiving their benefits and 1 client was incorrectly denied FAP benefits,” the termination letter said. “At least 7 of the clients made repeated phone calls to the In Contact line regarding not being contacted for required interviews. This not only causes frustration and stress for the clients, but also does not reflect the mission of the Department.”

Butler had been disciplined multiple times for falsifying documents, according to an April 2, 2024, email from Nathan Conley of the Michigan Civil Service Commission to Michael DeRose of the same agency.

“For some context and history: Mr. Butler does have a history of dicipline [sic] related to case processing, falsification, and policy violations. At one point he was brought back to work by an arbitrator. Fast forward to the more recent concerns which are similar to the past, we have noticed many cases have been falsified along with other various policy violations.”

Butler was hired in 2001 and worked for the state of Michigan for 23 years. The department has nearly 16,000 employees.

CapCon has reached out to every spokesperson for the health agency and none have responded to a request for comment. Neither has Hertel.

 

Scott McClallen is a reporter and editor for Michigan Capitol Confidential. 

McClallen came to Michigan from Southern Illinois to study economics at Hillsdale College. 

He previously worked for The Center Square for five years covering Michigan’s taxing and spending, electric vehicle subsidies and labor strikes. His work has appeared in RealClearPolitics, the Washington Examiner and the Detroit Metro Times. 

Raising goats, horses and chickens, he grew up on a farm, and now lives in Metro Detroit with his wife and dog. 



   
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Abigail Nobel
(@mhf)
Member Admin
Joined: 5 years ago
Posts: 1226
Topic starter  

Oct 28 MDHHS email update.

Attention all providers,

As an update to the alert posted October 21, 2025, MDHHS has corrected the issue of claims denying in error. Identified claims will be resurrected by MDHHS beginning this week.

Providers with additional questions should contact Provider Support at 1-800-292-2550 or by email at ProviderSupport@Michigan.gov .



   
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