CMS Announces Medicaid and School-Based Health Services Affinity Group

The federal Centers for Medicare & Medicaid Services (CMS) has announced the development of a new group for state Medicaid agencies interested in "partnering with schools and public health to improve access to and the delivery of important preventative health services for children and adolescents." Officially called the Medicaid and School-Based Health Services Delivery Affinity Group, this...

DHCS Releases Vendor Fee Worksheets for Backcasting & RMTS Invoices

The Vendor Fee Worksheet (VFW), a new mechanism by which DHCS will ensure that LEAs can only claim (i.e. be reimbursed) for up to 15% of their total invoice amount in vendor fees, was released on August 2 after a months-long revision process by DHCS. This form was required to complete the first round of backcasted invoices from the SMAA deferral, as well as annually for RMTS claims starting...

Senate Rejects Slimmed-Down Obamacare Repeal as McCain Votes No

"WASHINGTON — The Senate in the early hours of Friday morning rejected a new, scaled-down Republican plan to repeal parts of the Affordable Care Act, derailing the Republicans’ seven-year campaign to dismantle President Barack Obama’s signature health care law and dealing a huge political setback to President Trump. Senator John McCain of Arizona, who just this week returned to the Senate...

To Protect Children, Senate Republicans Must Drop Medicaid Per Capita Cap

"The Senate Republican health bill, like the House-passed bill, would convert Medicaid to a per capita cap, but it would cut Medicaid even more deeply and pose an even greater threat to coverage for all Medicaid beneficiaries — including children..." Read the full article: CBPP, June 23, 2017, To Protect Children, Senate Republicans Must Drop Medicaid Per Capita Cap | Center on Budget and...

The Medicaid Cap: “Carving Out” Medically Complex Kids Won’t Protect Them

"The Senate Leadership is reportedly including a cap on federal Medicaid payments to states in its version of legislation to “repeal and replace” the ACA.  That cap will apparently look a lot like the cap that narrowly passed the House in early May, but with some tweaks to accommodate concerns of individual Senators. One tweak under consideration has to do with “carving out” medically...

Schools Brace for Impact if Congress Cuts Medicaid Spending

"For school districts still getting their financial footing after the Great Recession, the Medicaid changes being advanced as part of the health care overhaul are sounding familiar alarms. Administrators say programming and services even beyond those that receive funding from the state-federal health care program could be at risk should Congress follow through with plans to change the way...

A Little-Noticed Target in the House Health Bill: Special Education

"WASHINGTON — While House Republicans lined up votes Wednesday for a Thursday showdown over their bill to repeal the Affordable Care Act, Vickie Glenn sat in her Murphysboro, Ill., office and prayed for it to fail. Ms. Glenn, a Medicaid coordinator for Tri-County Special Education, an Illinois cooperative that helps more than 20 school districts deliver special education services to students,...

Why ACA Repeal Efforts Hurt Schools & How to Get Involved

Efforts to repeal the Affordable Care Act (ACA), also known as Obamacare, continue to make headlines as members in Congress work to finalize a new replacement bill and bring it to a vote. With so much coverage, we thought it would be helpful to collect the best resources on the impact of ACA repeal and replacement efforts on school-based health and Medicaid billing programs. First, a quick...

SMAA Deadlines Extended and Backcasting Updates from DHCS

DHCS has published meeting minutes from their RMTS Workgroup meeting held on April 19, 2017. Of particular interest: SMAA invoice deadlines for 2015/16 Q1 and Q2 have been extended to July 31, 2017 and August 31, 2017 respectively Backcasting invoices for claims in excess of $25,000 from FY 2009/10 and 2010/11 are still due by June 30, 2017 (although work cannot begin until the final set...

Retroactive Guidance for California’s SMAA-RMTS Program May Signal Mass Invoice Revisions

**Update, April 20, 2017: DHCS has verbally stated that this new guidance does not supersede PPL 15-012. DHCS is currently drafting a new PPL to outline the process for handling 100% federally funded or ICR time survey participants that were inadvertently included in an RMTS pool; more details will be available once the new PPL is published.**   On March 30, 2017, DHCS sent an email...