Doing Our Part to Address Free Care

January 29, 2015 - San Francisco, CA - There has been a lot of buzz about the federal government's recent reversal of the free care rule, a policy that had effectively prevented schools from billing Medicaid for health services provided to their general education population. The reversal of this policy is the biggest thing to hit school Medicaid billing programs in the last decade and people are...

With Federal Policy Change, More Money for School-Based Health Services

A recent federal policy reversal, long-sought by states and health care advocates, could enable schools to take a lead role in managing chronic childhood diseases and result in the hiring of many more school nurses. The change, announced quietly and unexpectedly last month by the Centers for Medicare and Medicaid Services (CMS), will allow public schools to receive Medicaid money for health...

Schools Can Bill Medicaid for More Student-Health Services, Feds Say

Advocates for school-administered student health services say new guidance issued by a federal agency this week will allow schools to bill Medicaid for more services they provide to students. Those additional reimbursements could help bolster tight budgets for school-health programs, allowing them to provide more services, such as immunizations, mental health care, and screenings for conditions...

Huge Win for School Medicaid Programs as CMS Changes Restrictive Free Care Policy

The federal Centers for Medicare and Medicare Services (CMS) has issued a letter to all State Medicaid Directors withdrawing their prior guidance on the free care policy, Medicaid Payment for Services Provided without Charge (Free Care). This is welcome and exciting news for school districts that participate in their state's school-based Medicaid billing program, many of whom have been waiting...

You Inspire Us!

December 16, 2014 – San Francisco, CA – We at Paradigm believe that School Medicaid Billing Programs play a significant role in enhancing opportunities for students and families in our communities. Moreover, we know this would not be possible without the commitment, and dedication, to gathering the paper, signing the forms, and organizing the files—your daily work makes a difference for...

Children’s Health Insurance Program Deserves Funding

"Insuring kids isn't just an act of kindness; it's an investment in a better-educated, healthier and more productive population." In what may be a hopelessly quixotic effort, supporters of the federal Children's Health Insurance Program are trying to persuade Congress to renew its funding almost a year in advance — and in a lame-duck session. Nevertheless, lawmakers ought to heed that call....

“School-Based Health Centers” Could be the Future of Medicine for Teens

This isn't your mom's school nurse; it's a full medical center—in a high school. These school-based health centers are taking off in D.C. Here's why that's a good thing. While a school nurse can hand out band-aids and Tylenol, Jason Beverly, a medical provider at Anacostia Senior High School, can prescribe and administer antibiotics, allergy meds and more. Beverly is part of a movement in...

Report: Kansas Improperly Claimed $10.7M in Medicaid Reimbursements

KANSAS CITY, Mo. — Kansas improperly billed Medicaid for nearly $11 million in school-based health services, a government watchdog has found. In a report released Monday, the inspector general for the U.S. Department of Health and Human Services determined that Kansas received $10.75 million in unallowable reimbursements for services provided during the one-year period from July 1, 2009,...

A Healthy Child is a Better Student

 "I want to be a paleontologist," my young male patient said, squinting at a wrinkled clipping from the newspaper of a dinosaur skeleton at the museum as I examined him. An impressive aspiration for a 10-year-old who looked like he needed glasses, but more so because his family was homeless and had none of the resources that could propel a more fortunate child toward his goal. But like the tens...

CMS Releases Series of EPSDT Briefs, Addresses Medical Necessity Issues

Last week CMS published three new guides focused on Medicaid's Early and Periodic Screening, Diagnosis and Treatment (EPSDT) benefit. Over the past many years states as well as providers, patients and their families have raised questions about various aspects of EPSDT. The guides are intended to assist states in complying with CMS' interpretation of the EPSDT statute and regulations. The...