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Medicaid to Schools: Medical Assistance Services Provided by Education Agencies

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    • Thursday, June 2, 2020
      2:30-4:00 PM
      Please check this website for meeting details, including call-in instructions.

March 10, 2020

UPDATE on Medicaid to Schools Legislation

As you may have heard, the Governor signed SB 684 into law yesterday. A big thanks to all of you that put time and effort into reviewing the bill, proposing amendments, and attending hearings related to the bill.

The legislation accomplishes three important goals. First, SB 684 facilitates the provision of medical services in the school setting to students that are enrolled in participating public schools and in Medicaid by adding public schools to the list of settings where a licensed nurse may delegate the task of administering medicine.

Second, the legislation provides an efficient pathway for the Office of Professional Licensure (OPLC) to license qualified professionals that are certified by the Department of Education (DOE) and are providing health related services to New Hampshire students. Once licensed, schools may be able to seek federal funding for services provided by these licensed professionals. (More on licensing Adobe Acrobat Reader Symbol).

Third, SB 684 adds clarity to the two Medicaid to Schools statutes by addressing medical necessity and aligning the language between the two statutes.

As to licensing, there are provisions related to school psychologists, school social workers, and speech language specialists that are currently certified by and in good standing with the DOE, and were certified on the effective date of the legislation.

New Medicaid to Schools Rule

On Friday, February 21, 2020, the New Hampshire Joint Legislative Committee on Administrative Rules (JLCAR) voted unanimously to approve He-W 589, the new Medicaid to School rule Adobe Acrobat Reader Symbol put forward by the NH Department of Health and Human Services (DHHS). The purpose of the rule is to describe the services reimbursable under Medicaid. The rule was developed in collaboration with stakeholders including teachers, providers, the Governor’s office, legislators, advocates, the Office of Professional Licensure and Certification, and the Department of Education.

 

December 4, 2019

Governor Chris Sununu Signs Medicaid to Schools Executive Order

Today, Governor Chris Sununu signed an Executive Order that streamlines and expedites the process of licensing and credentialing applications for individuals who are providing services under the Medicaid to Schools Program.

A Medicaid to Schools Fact Sheet includes relevant background information on the rulemaking process, the executive order, and future legislation.

 

What is Medicaid to Schools?

Medicaid to Schools (MTS) is a benefit of the NH Medicaid state plan that offers local education agencies (LEAs) and school administrative units (SAUs) the opportunity to receive federal Medicaid dollars to offset costs for Medicaid covered services performed by qualified medical or behavioral health treatment providers in a school setting to a Medicaid eligible student.

To receive Medicaid payment for healthcare and health related services, schools, providers in schools, or school-based health centers must meet federal and state requirements for Medicaid providers (42 CFR 455.400-455.470).

NH Medicaid may cover services included in a Medicaid eligible student’s individualized education plan (IEP), Section 504 plan, or other written care plan when:

  1. The services are listed in Section 1905(a) of the Social Security Act and are medically necessary;
  2. All federal and state regulations are followed, including those specifying treatment provider qualifications;
  3. The student is Medicaid eligible; and
  4. The services are included in the state plan or available under Early and Periodic Screening, Diagnostic and Treatment (EPSDT) benefit.

Services covered under NH Medicaid via the MTS benefit include, but are not limited to, physical therapy, occupational therapy, speech pathology services, psychological counseling, nursing, and eligible transportation services.

On July 1, 2019 the Substance Abuse and Mental Health Services Administration (SAMHSA) and the Centers for Medicare and Medicaid Services (CMS) issued guidance on how states can expand access to behavioral health and substance use disorder treatment services in the school setting. In response, the Department of Health and Human Services moved the MTS benefit to the Division of Medicaid Services, and on August 27, 2019, adopted an Emergency Rule Adobe Acrobat Reader Symbol that continues coverage for services to Medicaid eligible students beyond those students with IEPs, and clarifies when schools can seek Medicaid reimbursement.

If you would like to submit a question or concern for the Department to address, please use the dedicated MTS e-mail: MTS@dhhs.nh.gov

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