Michigan Implements Universal Lead Testing Mandate for Children

With the new requirement, every child should take blood lead tests at 12 and 24 months. Moreover, testing must be done on children with a history of 24 to 72 months without prior test documentation. Repeat or additional testing, is also required among children who live in high-risk settings, such as in old housing or environments with known lead exposure.

This policy supersedes the risk-based screening policy used in the state of Michigan and indicates the emerging evidence that lead exposure in the community is possible not just in the traditionally high-risk regions. It is vital to detect it early because when children are exposed to lead, they may have developmental, cognitive, and behavioral impairments in the long run.

HEDIS Measure Alignment

The requirement is consistent with the recent changes in updated HEDIS Lead Screening in Children (LSC), the measure that follows the percentage of children tested for lead by the age of two. The LSC measure falls under the Child Core Set of Medicaid quality reporting.

To remain compliant, pediatric practices must ensure:

• Timely testing and documentation
• Accurate reporting through the Michigan Care Improvement Registry (MCIR)
• Follow-up for elevated results (≥ 3.5 µg/dL)

Health Care Provider Guidelines

The state health officials recommend the following steps be taken by the providers:

1. Revise clinical practice to incorporate regular lead screening at well-child visits at 12 and 24 months, and also catch-up testing to six years old.
2. Educate clinical and administrative personnel about the new requirements, such as parental opt-outs.
3. Report any blood lead test results to MCIR, with results being seen on immunization certificates.
4. Inform families about the need to identify lead at an early age and discuss issues concerning testing and follow-up treatment.
5. Measure and track compliance with HEDIS by monitoring screening rates and EHR notifications of missed tests or follow-ups.

Resources and Support

• Michigan Public Health Code – Lead testing
• MDHHS universal lead testing rule draft
• HEDIS MY 2025 measure descriptions
• MCIR

Providers can also access support through the UnitedHealthcare Provider Portal.