Empowering Schools with a Long-Awaited Guide: Delivering Care to Children in Medicaid and CHIP
The Centers for Medicare & Medicaid Services (CMS) has recently unveiled its long-awaited, comprehensive guide, titled "Delivering Service in School-Based Settings: A Comprehensive Guide to Medicaid Services and Administrative Claiming," which marks a significant milestone in the implementation of the Bipartisan Safer Communities Act (BSCA). This guide, developed in consultation with the U.S. Department of Education, aims to expand access to Medicaid health care services, including behavioral health, while reducing administrative burdens for states and schools.
Simplifying Administration for Enhanced Access
At Paradigm, we understand the vital role schools play in ensuring health access and equity for all students. Medicaid and the Children's Health Insurance Program (CHIP) already provide coverage to over half of all children in the United States. However, administrative complexities have often hindered schools from receiving proper reimbursement for Medicaid-covered services. That is why the new CMS guide offers game-changing flexibilities and consolidates existing guidance, enabling schools of all sizes and resource levels to overcome administrative barriers and efficiently receive payment for the services they provide.
Building Bridges Between Education and Healthcare
The guide's significance cannot be overstated. It serves as a bridge between education and healthcare, offering invaluable strategies for states to streamline processes, reduce administrative burden, and facilitate the delivery of healthcare services to eligible students. By adopting the guide's flexibilities, schools can pave the way for improved healthcare access, particularly for children with Medicaid and CHIP coverage in underserved communities.
Transforming Student Well-being and Outcomes
Numerous studies have demonstrated the positive impact of school-based health care services on students' health and academic achievements. By leveraging the guidance provided in the CMS guide, schools can offer an array of essential care services, including preventive care, behavioral health services, physical and occupational therapy, and disease management. This comprehensive policy guide equips schools with the necessary tools and resources to integrate healthcare seamlessly within the educational environment.
Guidance and Flexibility Tailored to School Settings
The CMS guide clarifies, consolidates, and expands upon a wealth of guidance from the Centers for Medicare & Medicaid Services. It addresses key aspects that affect schools directly, such as payment processes for Medicaid and CHIP school-based services, streamlining interim billing procedures, providing examples of approved payment methods utilized by state agencies, and facilitating the enrollment of qualified healthcare providers within school settings.
At Paradigm, we are committed to supporting schools in their mission to provide quality care and education to students. As a trusted partner, we actively monitor policy changes and developments to ensure our services align with the evolving landscape of education and healthcare. The release of the CMS guide represents a significant step forward, empowering schools to deliver the care students need and deserve.
View CMS’s full guide or informational bulletin for more information.
