Rule Eliminating Certain School-Based Medicaid Funding Rescinded by HHS

By February 2, 2015 News No Comments

Department of Health and Human Services (HHS) recently announced that the Department would reverse a December 2007 proposed rule issued by the Centers for Medicare and Medicaid Services (CMS) that would have limited access to school district Medicaid reimbursement. The 2007 proposed rule would have eliminated school-based Medicaid reimbursement for certain transportation and administrative healthcare services provided to students.

The particular services noted in the rule for which reimbursements would have been eliminated include:“administrative activities performed by school employees or contractors, or anyone under the control of a public or private educational institution, and transportation from home to school and back for
school-aged children with an Individualized Education Program (IEP) or an Individualized Family Services Plan (IFSP) established pursuant to the Individuals with Disabilities Education Act (IDEA).”

These services had been found by the Secretary to not meet the statutory test under section 1903(a)(7) of being “necessary . . . for the proper and efficient administration of the State plan.”

Had the rule gone into effect, approximately $3.6 billion in school reimbursements over the course of five years would have been impacted.

Contact Barb Erickson or Rupa Ramadurai with your Medicaid reimbursement inquiries.

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