Payer Updates

Payer Updates | January 2026

For a curated summary of the latest payer updates* impacting Northern Michigan provider offices, grouped by payer then category, please see below:

BCBSM and BCN

All Providers: All authorizations for Medicare Advantage Patients are being transferred to NASCO. SOURCE

Health Alliance Plan

All Providers: New prior auth platform coming in 2026; users will be asked to provide gender and DOB.

All Providers: New Enrollees with HAP’s Medicare Advantage Plan 
Munson has held a contract with HAP for one year, including Medicare and Commercial plans. HAP began broadly selling Medicare Advantage in our region during the 2026 Medicare Advantage Open Enrollment period.
We expect to see new enrollees under the HAP Medicare Advantage plan. Questions? Contact Laura Stuursma.

Humana

All Providers: Good News! Aetna launching new programs to reduce prior authorization administrative burden. SOURCE

Nomi Health

All Providers: Nomi Health is new Munson Healthcare contracted payor.

Nomi Health is a newer plan in the Michigan market. They offer self-funded employer group Commercial health plans.  

Munson has signed an employer specific case agreement. The case agreement covers Munson services at Tier 1 In-Network status for certain employer groups in our region. Tier 1 provider claims primarily process with no deductible or copayment. 

Nomi Health utilizes ASR for the majority of their operational services, such as member enrollment/eligibility, prior authorizations and claims processing.

These are the employer groups included in the Munson case agreement:

  • Odawa Casino (Petoskey)

  • Little River Casino (Manistee)

  • Goodwill Industries (Cadillac and Ludington)

  • Salisbury Trucking (Tustin)

  • Beneteau Boats (Cadillac)

 

*News items from the following payers were reviewed for this month’s highlighted articles: Aetna, BCBSM, Blue Care Complete, Blue Care Network (BCN), Health Alliance, McLaren, Molina, and Priority Health.