Medicaid Claiming for School-Based Health Services

In 2008, the Centers for Medicare & Medicaid Services (CMS) proposed the elimination of the reimbursement that school systems receive for administrative and transportation expenses from the Medicaid program. Under current law, school systems that provide health care services for children with disabilities via health clinics and health professionals are reimbursed for those services by Medicaid.



AASA Action: AASA opposes the proposed elimination of administrative and transportation claiming. In 2006 we worked with Sen. Edward M. Kennedy (D-Mass.) and Reps. John Dingell (D-Mich.) and Ed Whitfield (R-Ky.) to develop S 3705 and HR 5834, the Protecting Children’s Health in School’s Act of 2006. S 3705 and HR 5834 amend Title XIX of the Social Security Act to clarify the ability of schools to claim for administrative and transportation costs associated with services provided to students with disabilities and low-income students. We are actively seeking support for S 3705 and HR 5834 from other members of Congress, especially Republicans.

Victory! Thank you to everyone who contacted their Congressional offices. Due to your efforts and conversations, Congress acted to delay the Medicaid regulations. Congress passed an extension for a moratoria for six of the seven proposed Medicaid regulations— including administrative and transportation claiming — until April 1, 2009. Contact your representatives to urge their support for the moratoria.

Act Now! Make sure your member of Congress supports the legislation that would extend the moratoria against regulations that would eliminate school-based medicaid reimbursement for transportation and administrative training. HR 5613, the Protecting the Medicaid Safety Net Act of 2008, would extend the moratoria until April 1, 2009. AASA has provided talking points for your use.


AASA Joins More Than 140 Organizations in Letter Urging Support for Medicaid Moratoria:Read the letter in which a national coalition of more than 140 groups urge Congress to support the Medicad moratoria.

AASA Urges Congress to Block Proposed Changes to Medicaid Claiming. AASA joined 37 organizations and more than 550 school districts in signing a letter that urges Congress to block proposed regulations that would eliminate Medicaid reimbursement for transportation and administrative claiming. Read the letter.

Success Story: In April and May of 2008, AASA members from across the country sent more than 740 e-mails to Capitol Hill urging legislators to save Medicaid Reimbursement. The overwhelming presence of the AASA’s Legislative Corps and the overall AASA membership on the issue of Medicaid has made an invaluable difference. Every call, every e-mail and every letter has had an impact. We are not done yet. We cannot let up the pressure until we have a final resolution and we have ensured that the Medicaid regulations will not take effect prior to April 1, 2009. The current June 30 moratoria deadline on school-based Medicaid claiming is approaching quickly and it will be up to school system leaders across the country to make the case that a long-term solution must be found.


For More Information:

  • States Respond to CMS Regulations: A recent survey of State Medicaid Directors gives insight to the significant loss in federal revenue states can expect if the proposed CMS regulations go through. See how the proposed changes would affect federal funding in your state.
  • Letter to House Energy and Commerce Committee in Support of SCHIP reauthorization - The House version of the SCHIP legislation includes a one year moratorium on any regulations or changes in school based Medicaid claiming. Unfortunately, it fails to include the language AASA wanted pertaining to the Protecting Children’s health in Schools Act (HR 1017). (Word, July 2007)
  • Joint letter from AASA, the Council of Great City Schools, and the National School Boards Association - This letter urges members of the U.S. House of Representatives to co-sponsor the Children's Health in Schools Act (Word, September 2006)
  • Medicaid School-Based Administrative Claiming Guide (PDF, May 2003) - The Centers for Medicare & Medicaid Services propose the elimination of school-based claiming.
  • AASA Submits Response to CMS Medicaid Claiming Guide (Word document, December 2002) - AASA strongly urges CMS to delay implementation of the claiming guide and develop a new guide that promotes the health of children and supports their educational progress.
  • Analysis of School-Based Medicaid Law (PDF, March 2001) - This analysis was prepared for AASA and examines Medicaid as a secondary payer to other sources of health care financing, the prohibition against Medicaid payment for services that are available free of charge to community residents, and Medicaid as a “payer of last resort.