Introduction to School Medicaid for School Nurses

Author:

Bundy Bob1ORCID,Gormley Jenny M.2

Affiliation:

1. Professional Software for Nurses, Inc., Amherst, NH

2. Northeastern University School Health Academy (NEUSHA), Northeastern University Boston, MA

Abstract

School nurses are important participants in School Medicaid (SM) programs nationally. Yet, the complexity of SM programs and required documentation are major barriers to implementing this program for nurses. School nurses are often required to participate in the SM program without having a clear understanding of the purpose and components of the overall program. With the expansion of SM programs due to the Centers for Medicare and Medicaid Services “free care” guidance change, nursing services and documentation are receiving more attention and scrutiny as more nursing services become eligible for reimbursement in states across the country. This article presents a clear overview of SM, its history, different components of state SM programs, school nursing documentation and challenges, and resources for school nurses who are interested in more information.

Publisher

SAGE Publications

Subject

General Medicine

Reference15 articles.

1. Bipartisan Safer Communities Act. (2022). Pub. L. No. 117-159, 133 Stat 1313. https://www.congress.gov/117/plaws/publ159/PLAW-117publ159.pdf

2. Bundy B., Gormley J. (2022, October 24–27). School Medicaid challenges and opportunities for school nurses [Breakout session]. National Alliance for Medicaid in Education (NAME) 20th Annual Conference, Baltimore, MD, United States. https://pheedloop.com/EVERUHQZZGJJG/site/sessions/?id=SESUE11QU3XE7L31F

3. Centers for Medicare and Medicaid Services. (n.d.). History. https://www.cms.gov/about-cms/who-we-are/history#:~:text=for%2050%20years-On%20July%2030%2C%201965%2C%20President%20Lyndon%20B.,economic%20security%20of%20our%20nation

4. Centers for Medicare and Medicaid Services. (2014, December 15). SMD# 14-006 Re: Medicaid payment for services provided without charge (free care). Department of Health and Human Services. https://www.medicaid.gov/sites/default/files/federal-policy-guidance/downloads/smd-medicaid-payment-for-services-provided-without-charge-free-care.pdf

5. Centers for Medicare and Medicaid Services. (2023, May 18). Delivering services in school-based settings: A comprehensive guide to Medicaid services and administrative claiming. https://www.cms.gov/newsroom/fact-sheets/delivering-service-school-based-settings-comprehensive-guide-medicaid-services-and-administrative

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