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If you are looking for an older newsletter, contact Laura.

MESH Guide to School Medicaid Reimbursement

Promoting All Kids Health Insurance: Outreach and Enrollment Tips for Schools

Sample Parental Notice for Consent to Allow the School District to Access Medicaid Benefits

Sample parental consent form developed by the Illinois State Board of Education (ISBE).

Illinois Medicaid School-Based Health Services (SBHS) Program Changes Frequently Asked Questions: School Health and Mental Health Service Providers

FAQs on Illinois School-based Medicaid for school health service providers developed by HFS and ISBE.

Illinois Medicaid School-Based Health Services (SBHS) Program Changes Frequently Asked Questions: Local Education Agency (LEA) Business Officials

FAQs on Illinois School-based Medicaid for school business officials developed by HFS and ISBE.

LEA Handbook on School Medicaid Claiming

Official guidance from HFS (does not yet reflect changes in the State Plan Amendment).

PCG Claiming System

Portal for administrative claiming and cost settlement.

Illinois ABE Portal

Platform to assist Illinois families with applying for Medicaid and other benefits.

InsureKidsNow.gov

Numerous materials that districts can use for Medicaid outreach and enrollment.

How Illinois Can Leverage Medicaid Funds to Expand School Health Services

Building off Schools Are Key to Improving Children’s Health, this brief looks at the state of children’s health and school staffing in Illinois and outlines the steps Illinois must take to amend its Medicaid state plan and increase access to health services.

School Funding and the Illinois Healthy Student State Plan Amendment

In this recorded webinar, learn about a federal policy shift that allows billing for all health services provided to all students enrolled in Illinois Medicaid.

Frequently Asked Questions about the Illinois State Plan Amendment

Answers to common questions about the Illinois State Plan Amendment and the benefits and changes to school Medicaid reimbursement.

Medicaid 101 for School Superintendents

This brief explores what Medicaid is, what it covers—in and out of school—and how school districts can leverage Medicaid to enhance school health services.

Understanding the Early and Periodic Screening, Diagnostic, and Treatment Benefit

This webinar provides an overview of the Early and Periodic Screening, Diagnostic and Treatment Benefit (EPSDT) requirements.

Introduction to Expanding School Medicaid Programs Webinar

This webinar recording describes the Medicaid program and what it covers, discusses how school districts can leverage Medicaid to enhance school health services, and provides information about the free care policy reversal and how states are leveraging this opportunity to expand their school-based Medicaid programs. Tips are shared on how key stakeholders, including school health providers and school superintendents, can support this work in their states and communities.

Schools Are Key to Improving Children’s Health

This national policy brief addresses the opportunities to expand on health services delivered within a school by school nurses and other district-employed providers.

Office of the Inspector General School-Based Medicaid Reports: A Consolidated Review

This report reviews 33 audits of school-based Medicaid programs conducted by the Office of the Inspector General (OIG) and summarizes key findings. The report highlights what OIG looks for during audits and can be used to help states and school districts prepare for future audits. Sample checklists are included to help guide states toward developing robust internal guidance and policies that meet OIG expectations.

A Guide to Expanding Medicaid-Funded School Health Services

This comprehensive, step-by-step guide provides background on school-based Medicaid and outlines various opportunities to advance state policy changes required to access federal funds.

An In-Depth Look at Expanding School-Based Medicaid Programs

This recorded webinar provides an in-depth look at trends in expanding school-based Medicaid programs, including detailed information about how states have successfully structured their programs. Presenters from Colorado and Michigan share how they expanded their programs and highlight key decisions they made along the way.

Understanding Medicaid Reimbursement in the School Setting

Presentation delivered by CMS for the Healthy Students, Promising Futures Learning Collaborative providing an overview of Medicaid reimbursement in the school setting. The presentation addresses issues including the free care policy, certified public expenditures, and telehealth.

Documenting Medical Necessity Through Plans of Care

The policy brief explains the importance of using a plan of care to document medical necessity, which is required for all school health services submitted for Medicaid reimbursement, and offers guidance on implementing plans of care for students without an IEP or 504 plan.

Opportunities in Medicaid to Improve Access to Behavioral Health Care for Children and Youth

Presentation by Kirsten Beronio, Centers for Medicare and Medicaid Services.

State Medicaid and Education Standards for School Health Personnel

This report reviews reimbursement challenges across the country and demonstrates how alignment between state Medicaid and education standards for school health personnel can reduce barriers to Medicaid reimbursement for school health services.

Medicaid Coverage of Crisis Intervention Services in a School Setting

This brief considers the circumstances under which school districts can bill their state Medicaid program for sudden and acute mental health crises that students may experience.

Third Party Liability and School-Based Medicaid Services

This policy brief includes information on how third party liability (TPL) applies to school-based health services and offers resources for additional reading.

Expansion of School Medicaid Programs: An Opportunity to Ensure Qualified School Health Providers Are Medicaid-Eligible

In order to encourage school districts to maximize resources for school-based healthcare, state Medicaid programs must ensure that school healthcare providers are eligible for Medicaid reimbursement. This policy brief explains how states can resolve identifying school health personnel as Medicaid-qualified providers and shows how six states improved alignment.

Case Studies: How States Are Expanding School Health Services Using Medicaid

These case studies reflect the work states have completed, and the success they have achieved, in leveraging federal Medicaid policy to expand physical, behavioral, and mental health services.

Expanding Michigan’s School-Based Medicaid Program

This Healthy Students Promising Futures Learning Collaborative case study highlights Michigan’s work to leverage the reversal of free care policy to expand the state’s school-based Medicaid program.

State Efforts to Expand School Health Services: Activity Tracker

This regularly updated brief tracks state efforts to expand access to school health services, either through a state plan amendment or through legislative/administrative action, allowing school districts to bill Medicaid for health services delivered to all Medicaid-enrolled children.