AB 236

Previously, under federal law, services that were provided to a Medical

Assistance recipient that were available without charge to the recipient or that were

obligated to be paid by a third party were generally not covered under the Medical

Assistance program. This policy was interpreted by the federal Centers for Medicare

and Medicaid Services to generally prevent schools from receiving reimbursement

for services provided to students who were enrolled under the Medical Assistance

program if the school did not bill for those services or if the school was obligated to

provide the services, even if the services provided were otherwise reimbursable

under the Medical Assistance program. CMS withdrew its prior guidance on this

policy on December 15, 2014.

This bill requires the Department of Health Services to submit to the federal

Department of Health and Human Services a state plan amendment to allow any

school to seek reimbursement under the Medical Assistance program for behavioral

health services provided in a school-based setting to a student who is a Medical

Assistance recipient that would otherwise be covered under the Medical Assistance

program. The Medical Assistance program is a joint federal and state program that

provides health services to individuals who have limited financial resources.