This article breaks down what care providers and case managers need to know when a resident in group residential care wants to transition to an apartment-style setting under Michigan's No-Fault system. It explains why resident preference alone isn't...
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This article breaks down what care providers and case managers need to know when a resident in group residential care wants to transition to an apartment-style setting under Michigan's No-Fault system. It explains why resident preference alone isn't sufficient justification, especially when Attendant Care (S5125) is added to the plan of care, and outlines the clinical documentation and physician language required in an updated Treatment Plan to support medical necessity, defend the cost differential, and withstand insurer review under MCL 500.3107(1)(a).
Keywords: Michigan No-Fault, Attendant Care S5125, apartment-style transition, group residential care, catastrophic injury case management, Treatment Plan documentation, medical necessity, physician justification, MCL 500.3107, least restrictive care, reasonable and necessary standard, No-Fault insurance appeals, care coordination Michigan, behavioral health transition, DCTRC
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