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To: Superintendents, Business Managers, Education Service District Special Education Directors, District Special Education Directors, School Medicaid Personnel, K-12 Public Information Officers
From: Jennifer Dundon, School Medicaid Operations and Policy Analyst
Date: August 6, 2026
Re: Application Now Available: School-Based Health Services Medicaid Pilot Cohort 2
Dear Education Partners,
The Oregon Department of Education (ODE) is excited to support the Oregon Health Authority’s (OHA) invitation to School Districts (SDs) and Education Service Districts (ESDs) to apply for the second cohort of the School-Based Health Services (SBHS) Medicaid Billing Pilot.
The Pilot is specific to billing for services provided pursuant to the Individuals with Disabilities Education Act (IDEA). The Pilot intends to build a sustainable SBHS Medicaid program within each participating Education Agency (EA).
SBHS Pilot Project Opportunity
Participants will have the opportunity to:
- Receive services from a Medicaid Billing Vendor (ORMED) at no cost to the EA through June 30, 2028.
- Participate in the program with dedicated support and training from OHA, ODE, and the ORMED teams.
- Be part of a cohort of Oregon EAs to share ideas, support continued momentum, and learn from each other.
Duration: Pilot kickoff will begin in fall 2026 and continue through June 2028.
Target Participants: SDs and ESDs that are committed to building and sustaining their IDEA School Medicaid program and are in the beginning stages of startup. Please note: For ESDs to participate in IDEA K-12 billing, they must have an agreement with the school district responsible for providing a free appropriate public education (FAPE).
Required Tasks: Each participating SD and ESD will enroll as an OHA School Medical Provider by September 18, 2026, and identify and create a School Medicaid Implementation Team that includes an administrator lead and staff who are critical to the success of the program. Representatives will include staff from: student services, school health services, business services, technology services, licensed practitioners (employed and/or contracted), and support staff.
Support Provided: Participants will receive 1:1 check-ins, implementation support, initial and ongoing staff training, and onboarding to ORMED.
Click here for the Cohort 2 Pilot Application
Key Dates
- The Cohort 2 Pilot Application is now available and is due October 16, 2026.
- EAs must submit IDEA OHA School Medical provider enrollment forms by September 18, 2026.
- OHA expects to notify applicants about their selection to participate in the pilot project by the end of October 2026.
Action Needed
Submit the Cohort 2 Pilot Application by October 16.
To prepare for the SBHS Medicaid Pilot Cohort 2 application:
- Please review this instructional SBHS Medicaid Billing Pilot slide deck.
- If you are an ESD, you must have an executed agreement with the school district responsible for providing a FAPE to participate in SBHS Medicaid billing.
- If your SD or ESD is not enrolled as an IDEA School Medical provider, you must apply to enroll with OHA by September 18, 2026.
- Register for our optional OHA Billing Provider Enrollment Office Hours for School Medical Providers
- Identify an individual to lead the Cost Benefit Analysis work.
- We recommend that this individual be a person at your SD or ESD who is familiar with services provided to students or can coordinate the effort required to perform the analysis.
- We have created this optional tool to support identifying and estimating which services will result in the most reimbursement potential.
- Register for our optional School Medicaid Cost Benefit Analysis Office Hours
- Identify an SBHS Medicaid project lead and key partners. The SBHS Medicaid Readiness Assessment Tool may help you get started.
- Review available OHA training and webinars on OHA’s School-Based Health Services website.
Contact Us
- For any questions regarding the SBHS Medicaid Pilot, please contact the OHA School-Based Health Services Medicaid Team at medicaid.sbhs@oha.oregon.gov.
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