Map: School Medicaid Programs

Related Report: A 50-State Review: Medicaid & State Standards for School Health Professionals. State Fact Sheets: For a school Medicaid summary of your state, view School Medicaid Fact Sheets. As of October 2023, 25 states have taken steps to expand their school Medicaid program to cover services… Read More

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School Medicaid Expansion: How (and How Many) States Have Taken Action to Increase School Health Access and Funding

October 17, 2023

As of October 2023, Healthy Schools Campaign has identified 25 states that have expanded their school Medicaid program to cover services outside of an IEP/IFSP using the “free care” policy reversal.

This brief provides a summary of the actions each state took, along with related state documents and other resources that may be helpful to states working to increase access to and funding for physical, behavioral and mental school-based health services.

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Download: School Medicaid Expansion: How (and How Many) States Have Taken Action to Increase School Health Access and Funding

School Medicaid Guidance: What Advocates and State Policymakers Need to Know

October 17, 2023

In May 2023, the Centers for Medicare and Medicaid Services released new school Medicaid guidance affirming that states have flexibility in their school-based Medicaid program to allow school districts to bill Medicaid for health services delivered to all Medicaid-enrolled children.

This brief answers key questions about the guidance and highlights what policymakers and advocates need to know — and how to get involved — to ensure states are best positioned to leverage federal opportunities increasing children's access to the services they need.

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Download: School Medicaid Guidance: What Advocates and State Policymakers Need to Know

Preliminary Discussion: School Medicaid Guidance Coverage Provisions

June 6, 2023

This memo summarizes new school Medicaid guidance released in May 2023 by the Centers for Medicare and Medicaid Services (CMS) and also draws from CMS’ August 2022 Informational Bulletin. It provides an initial assessment of how states could move forward to expand and enhance their school Medicaid programs.

This guidance makes clear that:
● All Medicaid-enrolled students can be covered for school-based health services.
● All medically necessary services, including preventive, physical, mental health and substance use disorder services can be covered in a school setting.
● States are able to support a wide range of providers in a school setting.
● Students covered by CHIP can be included in school Medicaid.

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Download: Preliminary Discussion: School Medicaid Guidance Coverage Provisions

School Medicaid Survey

June 6, 2023

The School Medicaid Survey was developed to provide visibility into how each state sets up its school Medicaid program and to enable states to find programs that might be similar to theirs. The Survey includes information about school Medicaid expansion, billing and reimbursement, administrative claiming, state audits, random moment time studies, and more.

All 50 states plus the District of Columbia (D.C.) were invited to participate; a total of 38 states and D.C. responded. Information was provided by state Medicaid and state education agency staff between April and December of 2022.

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Download: School Medicaid Survey

Webinar: New Medicaid Rules for Schools

June 6, 2023

Presentation slides from a June 6 webinar on the newly published school Medicaid guidance are now available online.

Featuring CMS Administrator Dan Tsai and OSERS Director Katy Neas, the webinar was co-sponsored by Healthy Schools Campaign, AASA and the National Alliance for Medicaid in Education (NAME).

The webinar covered:
● Policy shifts in the new school-based services Medicaid guidance
● Complementary policy changes at the U.S. Department of Education to expand school-based Medicaid reimbursement
● How the new guidance will reduce the administrative burden on districts and states
● Steps and supports available to states to expand and strengthen their school-based Medicaid programs
● How AASA, NAME and HSC can support state and district implementation efforts

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View: The New Medicaid Rules for Schools