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

October 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.

Expanding school Medicaid can take months or years to complete; the timing depends on the changes a state chooses to make and how it implements those changes. It is therefore important for state Medicaid agencies to begin the work now, with input from LEAs, school health advocates, school-based health providers and other stakeholders.