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SB 1058

Relating to a habitat conservation plan.

2025 Regular Session Introduced by David Smith

Michigan Medicaid must cover remote ultrasounds and fetal NSTs via telemedicine, with FDA-cleared, HIPAA-compliant tech; DHHS will set reimbursement rules and guidelines.

In committee upon adjournment.
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Bill Summary · SB 1058

SB 1058 — Summary (Medical assistance coverage for remote ultrasounds and fetal nonstress tests)

Status: Enacted — Signed by Governor May 13, 2025; effective January 1, 2026
Statute amended: Adds sections 109q and 109r to 1939 PA 280 (MCL 400.1–400.119b) — the Social Welfare Act
Primary sponsors (Senate): Senators Sarah Anthony, Erika Geiss, and Sylvia Santana

Main purpose

Require the Michigan Department of Health and Human Services (DHHS) to cover ultrasound procedures and fetal nonstress tests (NSTs) performed remotely (in a patient’s residence or other off‑site location) via telemedicine under the state’s medical assistance programs, and to adopt reimbursement rules and implementation guidelines to allow such coverage.

Key provisions

  • Coverage mandate (new MCL 400.109q): DHHS must provide medical assistance coverage for ultrasound procedures and fetal nonstress tests performed remotely in a residence or other off‑site location through telemedicine.
  • Reimbursement rules (new MCL 400.109r):
    • DHHS must amend fee‑for‑service and managed‑care reimbursement rules to permit payment for remote ultrasounds and NSTs using the established CPT procedure codes when the patient is physically off‑site from the provider and the same standard of care is met.
    • Remote ultrasounds are reimbursable only if the provider:
    • Uses digital technology to collect medical/health data and securely transmit it to a remote provider for interpretation/recommendation; and
    • The technology is HIPAA‑compliant and approved by the U.S. Food and Drug Administration (FDA).
    • Remote fetal NSTs are reimbursable only when:
    • The remote‑ultrasound technology requirements above are satisfied; and
    • The service has an at‑home monitoring place‑of‑service modifier and uses remote monitoring solutions that are FDA‑cleared for on‑label monitoring of fetal heart rate, maternal heart rate, or uterine activity.
  • Implementation: DHHS must adopt and publish guidelines to implement these provisions.

Who is affected

  • Medicaid/HMP (Healthy Michigan Plan) enrollees who are pregnant or receiving prenatal monitoring — expands where certain prenatal monitoring services can be accessed (at home/other off‑site).
  • Providers and vendors offering prenatal imaging and remote monitoring — must use HIPAA‑compliant, FDA‑approved/cleared systems and bill using established CPT codes and appropriate place‑of‑service modifiers.
  • DHHS and contracted Medicaid managed‑care plans — required to amend reimbursement rules, issue guidance, and monitor compliance.

Fiscal and operational impact

  • Fiscal impact to the state Medicaid program is uncertain. Michigan’s Maternity Outpatient Medical Services (MOMS) currently covers radiology and ultrasound in some contexts, but extending coverage to remote/home settings and reimbursing remote NSTs may increase utilization and costs depending on current practice and uptake.
  • The bill directs DHHS to amend rules and publish guidance; administrative rule‑making and oversight will be required before full implementation.

Effective date and implementation timeline

  • Enacted May 13, 2025; statute takes effect January 1, 2026. DHHS must amend rules and publish guidelines to implement the law in advance or concurrent with the effective date.

Compiled from official sources — confirm details with the bill’s official record.

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