Evidence status: CURRENT SCOPE CLASSIFICATION. Michigan’s opioid-related signatures must be classified by legal function before they can be compared or challenged.

1. Statewide opioid education acknowledgment

The Start Talking requirement applies to outpatient opioid prescribing within the statute’s scope. Its function is to document opioid-risk education and patient acknowledgment.

2. Medicaid high-MME Pain Medication Agreement

This agreement operates inside Medicaid managed-care prior authorization when the member exceeds the current high-MME threshold and no listed exception removes the additional criteria.

3. Workers’ compensation opioid treatment agreement

This agreement operates inside the workers’ compensation reimbursement framework for qualifying chronic, non-cancer opioid treatment beyond 90 days and must be renewed every six months.

4. Private clinic or payer terms

A private Michigan practice, health system, or payer may add conditions beyond the minimum requirements of any state program. Those terms should be identified as institutional policy unless another controlling source is proven.

Seeds of Vice classification rule

Every Michigan agreement should be reviewed clause by clause and coded as: statewide statutory acknowledgment; Medicaid coverage condition; workers’ compensation rule requirement; institutional or payer policy; or unresolved pending verification.

Reviewed: October 5, 2026.