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Michigan - Adult Companion Services — Licensing, Medicaid Enrollment and Startup Requirements

Last reviewed: 2026-09-10

The Michigan Department of Health and Human Services (MDHHS) does not cover or license a distinct service named Adult Companion Services, instead funding non-medical supervision and socialization through Community Living Supports (CLS) under the MI Choice and Habilitation Supports (HSW) 1915(c) waivers. Providers delivering these services operate as atypical Medicaid providers delivering CLS to ensure individuals remain safely in their homes and communities.

Approval to bill for these services requires an applicant to secure a direct subcontract with a regional MI Choice Waiver Agency or a Prepaid Inpatient Health Plan (PIHP) before submitting an enrollment application. Without an active contract from one of these regional designating entities, an agency cannot receive authorizations or reimbursement through the Community Health Automated Medicaid Processing System (CHAMPS).

1. Service Definition and Scope

Because Michigan does not use the Adult Companion Services billing category, providers deliver these supports under the Community Living Supports (CLS) definition. CLS encompasses non-medical supervision, socialization, and assistance with activities of daily living.

The service is designed to prevent institutionalization by providing a trained worker to prompt, cue, or supervise the participant in their unlicensed private residence.

2. Regulatory and Oversight Agencies

MDHHS sets the overarching policy, waiver definitions, and Medicaid enrollment rules for all HCBS providers in the state. Regional entities handle the actual contracting, credentialing, and daily oversight of CLS providers.

Providers must interact with both the state Medicaid system for baseline enrollment and their regional agency for service authorizations.

3. Gatekeeping Prerequisites: Who Can Even Apply

Michigan utilizes a closed-network model for waiver services, meaning MDHHS does not accept open, standalone applications for CLS providers to bill the state directly. An agency must be selected by a regional waiver entity.

These regional entities procure providers based on local network adequacy needs, often utilizing specific Request for Proposal (RFP) windows or closed networks.

4. Licensure and Certification Requirements

Michigan does not issue a specific state facility or agency license for non-medical in-home CLS or companion providers. Instead, providers are certified through the regional waiver agency's credentialing process.

Providers must demonstrate compliance with the MDHHS Minimum Operating Standards for MI Choice Waiver Program Services and the federal HCBS Final Rule.

5. Medicaid Provider Enrollment

All providers serving Michigan Medicaid beneficiaries must enroll in the Community Health Automated Medicaid Processing System (CHAMPS). CLS providers typically enroll as atypical providers.

Enrollment in CHAMPS is a screening mechanism; it does not guarantee payment without the corresponding regional waiver agency contract.

6. Staffing, Training and Background Checks

Direct care workers providing CLS must meet baseline qualifications established by MDHHS and verified by the employing agency. Agencies must maintain personnel files proving compliance.

Background checks are mandatory and must be completed before a worker has direct contact with a waiver participant.

7. Documentation, Policies and Records

Agencies must maintain comprehensive records to survive audits from both MDHHS and their contracting regional agencies. Documentation must prove that services were delivered exactly as authorized.

Michigan is implementing Electronic Visit Verification (EVV) for personal care and related in-home services, which impacts how CLS time is tracked.

8. Billing, Rates and Claims

CLS providers do not bill MDHHS directly through CHAMPS for waiver services. Instead, they submit claims or invoices to their contracting MI Choice Waiver Agency or PIHP.

Rates are established by the regional entities within parameters set by MDHHS, meaning reimbursement can vary by county or region.

9. Approval Sequence and Timeline

The timeline to become a billable provider depends entirely on the procurement schedule of the local waiver agency. If a network is closed, an agency cannot proceed.

Once a contract is offered, the CHAMPS enrollment and credentialing process typically takes several weeks to finalize.

10. Common Denials and Survey Findings

New applicants are most frequently denied because they attempt to enroll in CHAMPS without first securing a regional contract. Auditors frequently cite established providers for documentation failures.

Failure to maintain strict background check compliance is a severe finding that results in immediate recoupment of funds.

11. Key Contacts and Resources

Providers must rely on MDHHS for systemic rules and CHAMPS support, but must contact their local waiver agencies for contracting and rate information.

The MDHHS Medicaid Provider Manual is the definitive source for all coverage rules.

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