New CMS guidance on Medicaid claiming for school-based services

Washington State Health Care Authority sent this bulletin at 06/16/2023 12:00 PM PDT

June 16, 2023

New CMS guidance on Medicaid claiming for school-based services

Last month, the Centers for Medicare & Medicaid Services (CMS) released new guidance on Medicaid claiming for school-based services and administrative activities.

The Health Care Authority (HCA) is the single state agency that oversees Apple Health (Medicaid) in Washington State. HCA is issuing the following notification to provide background information on the history of federal and state school-based Medicaid reimbursement as well as how the new CMS guidance may impact HCA’s school-based Medicaid programs.

Read HCA's statement about the new CMS guidance

More information

Since the release of the guidance, HCA has been meeting with other state Medicaid agencies and our federal partners at Healthy Schools Campaign, Healthy Students, Promising Futures, and CMS. Many questions still need to be answered and clarification is needed from CMS on some of the flexibilities outlined in the guide. CMS has stated they will provide additional guidance and clarifications and are setting up a technical assistance center as state Medicaid agencies and state education agencies move forward in exploring the options outlined in the guide.

In addition to meeting with other state Medicaid agencies and federal partners, HCA also plans to convene a workgroup to begin exploring additional Medicaid reimbursement opportunities for Washington LEAs. HCA is committed to partnering with stakeholders and LEAs to ensure all LEAs are able to access Medicaid funding for Medicaid-covered services provided in the school setting.

Contact

Email HCA's Office of Community Services Section Manager Todd Slettvet with any questions.

About the Health Care Authority (HCA)

The Washington State Health Care Authority (HCA) is committed to whole-person care, integrating physical health and behavioral health services for better results and healthier residents.

HCA purchases health care for more than 2.5 million Washington residents through Apple Health (Medicaid), the Public Employees Benefits Board (PEBB) Program, the School Employees Benefits Board (SEBB) Program, and the COFA Islander Health Care Program. As the largest health care purchaser in the state, we lead the effort to transform health care, helping ensure Washington residents have access to better health and better care at a lower cost.

Please do not reply directly to this message. For more information, visit the HCA website, where you'll also find contact information.

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The Washington State Health Care Authority (HCA) complies with all applicable federal and Washington state civil rights laws and is committed to providing equal access to our services. Visit HCA’s website to view complete nondiscrimination statements.