Say Ahhh! CHIP Medicaid

Bipartisan Safer Communities Act Greenlights Updated School-Based Medicaid Guidance, TA Center and Grant Funding

July 18, 2022 Margaux Johnson-Green, Anne Dwyer

On June 25, President Biden signed the Bipartisan Safer Communities Act into law. While a high-level overview of the legislation has previously been detailed on SayAhhh!, with the language now enacted into law, we thought it would be helpful to drill down into more detail on the provisions relating to Medicaid and CHIP and school-based services.

Section 11003 of the Bipartisan Safer Communities Act entitled, “Supporting Access to Health Care Services In Schools,’” grants the long-awaited wishes of many school Medicaid advocates by requiring updates to outdated billing guides and providing more assistance to states, local education agencies (LEAs), and school-based entities seeking Medicaid reimbursement for school-based services. More specifically, the law:

  • Requires the Secretary of Health and Human Services (HHS), in consultation with the Secretary of Education, to issue guidance to support the delivery of services to students covered by Medicaid and CHIP in school-based settings. The guidance, which is required to be issued within one year of enactment of the law, must include:
    • Updates to the 2003 Medicaid School-Based Administrative Claiming Guide, 1997 Medicaid and Schools Technical Assistance Guide, and any other relevant guidance currently in effect;
    • Clarification that school-based entities can receive reimbursement for Medicaid-covered services rendered to Medicaid-enrolled students in an Individualized Education Program (IEP) and via the existing free care policy reversal, under which states can expand their school Medicaid programs to Medicaid covered students without an IEP;
    • Strategies and tools to reduce administrative burden and simplify billing for LEAs, including by aligning direct service billing and school-based administrative claiming payment systems;
    • A comprehensive list of best practices, as well as state and local examples of how to finance and expand EPSDT and telehealth services and implementing the free care policy reversal in states that have not yet taken up the option; and
    • Examples of types of providers that states may choose to cover as qualified school-based health providers for purposes of Medicaid reimbursement and best practices for helping to get those providers enrolled in Medicaid to receive such reimbursement.
  • Requires the Secretary of HHS, in consultation with the Secretary of Education, within one year of enactment, to establish a technical assistance center, for the purposes of:
    • Expanding the capacity of state Medicaid agencies, LEAs, and school-based entities to provide assistance under Medicaid;
    • Reducing administrative burden and supporting these entities in receiving reimbursement for Medicaid-covered services;
    • Ensuring ongoing collaboration between HHS and the Department of Education; and
    • Providing information to state and local education agencies on how to utilize funding.
    • The language also requires the Secretary to ensure that the TA center includes resources specifically designed to support small and rural schools and issue biennial reports on the TA centers work while also providing $8 million in funding for the center.
  • Provides $50 million for fiscal year 2022 for the Secretary of HHS to award grants to states to implement, enhance, or expand the provision of assistance through school-based entities under Medicaid or CHIP.

More details on the $50 million in Medicaid and CHIP focused school grant funding – such as whether or not states will need to apply, how and when the funds will be distributed, and whether HHS will require states to submit additional information on their plans for the funds – are still forthcoming. We will continue to watch closely and keep you updated as we learn more.

Notably, in addition to the Medicaid and CHIP-related provisions under Section 11003, the Bipartisan Safer Communities Act also includes a billion dollars in grant funding for school-based programs run by the Department of Education. This includes $500 million for fiscal years 2022 through 2026 for the School Based Mental Health Services Grant program – which supports the number of qualified mental health service providers that provide school-based mental health services – and $500 million for the Mental Health Services Professional Demonstration Grant program – which focuses on supporting training for school-based mental health service providers.

While we wait to see what comes nexts, as we’ve written about on Say Ahhh!, the Biden Administration has clearly set the stage for their commitment to improving school-based health services. We look forward to hearing more from them soon on next steps. We will continue to keep track and keep you posted.

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