Resources

State Policy Actions: 10 Steps to Maximize Medicaid for School Health Services

The following policy actions are recommended for all states to comprehensively expand their school Medicaid program and maximize Medicaid reimbursement for school districts. These actions align with federal school Medicaid guidance published in 2023 by the Centers for Medicare and Medicaid Services (CMS). The Bipartisan Safer Communities Act required CMS to expand access to Medicaid-covered … Continue reading "State Policy Actions: 10 Steps to Maximize Medicaid for School Health Services" Read More

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