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2020 12 03 15 49 12



On behalf of the Connecting Kids to Coverage National Campaign, we’re excited to share information about our next webinar on February 18, 2021, “Connecting Children to Coverage and Care: Medicaid and CHIP Comprehensive Dental Benefits Help Children Achieve Better Health and Healthier Smiles.” Additional information about the webinar and registration link are included here (Register Now!).



The Center for Connected Health Policy has released their State by state status report on telehealth.  Click below to keep informed about telehealth-related laws, regulation and Medicaid programs in your state.





Telehealth Services in Medicaid and Medicare  

Today, the Centers for Medicare & Medicaid Services (CMS) expanded the list of telehealth services that Medicare Fee-For-Service will pay for during the coronavirus disease 2019 (COVID-19) Public Health Emergency (PHE). CMS is also providing additional support to state Medicaid and Children’s Health Insurance Program (CHIP) agencies in their efforts to expand access to telehealth.

Expanding Medicare Telehealth Services

For the first time using a new expedited process, CMS is adding 11 new services to the Medicare telehealth services list since the publication of the May 1, 2020, COVID-19 Interim Final Rule with comment period (IFC). Medicare will begin paying eligible practitioners who furnish these newly added telehealth services effective immediately, and for the duration of the PHE. The list of these newly added services is available at: https://www.cms.gov/Medicare/Medicare-General-Information/Telehealth/Telehealth-Codes.

In the May 1 COVID-19 IFC, CMS modified the process for adding or deleting services from the Medicare telehealth services list to allow for expedited consideration of additional telehealth services during the PHE outside of rulemaking. This update to the Medicare telehealth services list builds on the efforts CMS has already taken to increase Medicare beneficiaries’ access to telehealth services during the COVID-19 PHE.

Preliminary Medicaid and CHIP Data Snapshot on Telehealth Utilization and Medicaid & CHIP Telehealth Toolkit Supplement

In an effort to provide greater transparency on telehealth access in Medicaid and CHIP, CMS is releasing, for the first time, a preliminary Medicaid and CHIP data snapshot on telehealth utilization during the PHE. This snapshot shows, among other things, that there have been more than 34.5 million services delivered via telehealth to Medicaid and CHIP beneficiaries between March and June of this year, representing an increase of more than 2,600% when compared to the same period from the prior year. The data also shows that adults ages 19-64 received the most services delivered via telehealth, although there was substantial variance across both age groups and states.  

To further drive telehealth, CMS is releasing a new supplement to its State Medicaid & CHIP Telehealth Toolkit: Policy Considerations for States Expanding Use of Telehealth, COVID-19 Version that provides numerous new examples and insights into lessons learned from states that have implemented telehealth changes. The updated supplemental information is intended to help states strategically think through how they explain and clarify to providers and other stakeholders which policies are temporary or permanent. It also helps states identify services that can be accessed through telehealth, which providers may deliver those services, the ways providers may use in order to deliver services through telehealth, as well as the circumstances under which telehealth can be reimbursed once the PHE expires.

The toolkit includes approaches and tools states can use to communicate with providers on utilizing telehealth for patient care. It updates and consolidates in one place the Frequently Asked Questions (FAQs) and resources for states to consider as they begin planning beyond the temporary flexibilities provided in response to the pandemic.

To view the Medicaid and CHIP data snapshot on telehealth utilization during the PHE, please visit: https://www.medicaid.gov/resources-for-states/downloads/medicaid-chip-beneficiaries-COVID-19-snapshot-data-through-20200630.pdf.


HHS Extends Public Health Emergency 

On October 2, U.S. Department of Health and Human Services Secretary Alex Azar announced an additional extension of the COVID-19 public health emergency (PHE). This declaration becomes effective October 23. Assuming a full 90-day declaration from this extension, the PHE will now last through January 21, 2021. 

HHS Announces $20 Billion in Third Distribution of Provider Relief Fund 

On October 1, the Department of Health and Human Services announced a third phase of general distribution funding from the Provider Relief Fund (PRF). HHS is allocating $20 billion for this funding round, with details on eligibility and payment methodology available here. The application period for this third round opens on Monday, October 5 and closes on November 6. Brief notes on eligibility and payment aspects are below. 

  • Eligibility: Any provider that has previously received, accepted, or rejected a general distribution award; behavioral health providers; and health care providers that began practicing between January 1, 2020 and March 31, 2020. 
  • Payment Methodology: Initial payments will be made to any provider that has not yet received a total of two percent of net patient revenue from the PRF, including providers who have received no PRF payment to date or providers who have received some payment below two percent of net patient revenue. With the remaining $20 billion after these payments, add-on payments will be made based on changes in a provider's net patient revenue and operating expenses, with consideration for any previous PRF funding awards made to that provider. 


3rd Virtual Learning Event Announced

Save the date! October 14, 2020, 2pm ET, CMS Update: Behavioral Health and Delegated Authority

This webinar, presented jointly by the National Alliance for Medicaid in Education (NAME) and Healthy Schools Campaign, will provide an update from CMS on behavioral health and delegated authority. 


Click Here  for more information on membership or to login to the members only site.



Next Virtual Learning Event Announced

Save the date! September 30, 2020, 2pm EST, Opportunities for School-Based Telehealth during COVID-19 

This webinar, presented jointly by the National Alliance for Medicaid in Education (NAME) and Healthy Schools Campaign, will provide an overview of the laws, regulations and policies that govern the delivery of telehealth in schools and how utilization can support access to care for Medicaid eligible students.


Click Here  for more information on membership or to login to the members only site.



Ohio: Seeking to Make Medicaid Telehealth Expansions Permanent

September 01/2020: Ohio Medicaid has filed permanent rules to continue expanded telehealth options beyond the COVID-19 public health emergency. The Department sited preliminary data in their decision-making, which showed that telehealth was very popular, especially for behavioral health services.  "This permanent expansion of clinically appropriate telehealth services allows us to increase access to quality care while maintaining the fiscal sustainability and integrity of Ohio's Medicaid program," said Ohio Medicaid Director Maureen Corcoran in a statement.

Read more about Ohio's telehealth expansion here



On 06/30/2020, Centers for Medicare & Medicaid Services issued a COVID – 19 FAQ for State Medicaid and CHIP Agencies. 

Please click on the link below to access the full FAQ.




HHS Announces Medicaid and CHIP Provider Relief Funding Award Details

On June 9, the U.S. Department of Health and Human Services (HHS) released details on how the Department intends to disburse funding to Medicaid providers from the provider relief fund.

Key details on the Medicaid awards: 

  • Total Amount: $15 billion for Medicaid providers.
  • Eligibility: Any provider that did not receive a funding award from the first $50 billion in awards made to providers with some level of Medicare utilization, and directly billed a state Medicaid program or Medicaid managed care plan between January 1, 2018 and May 31, 2020.
  • Process: Providers submit annual patient revenue information to HHS's provider relief fund portal by July 20, 2020.
  • Award Amounts: Minimum of two percent of gross patient care revenues, with final amount determined by provider-submitted data including number of Medicaid patients served. 



CASE Navigating Special Education and Remote Learning

The Council of Administrators for Special Education/Let’s Go Learn has passed along the PDF slide deck from their latest webinar, Navigating Special Education and Remote Learning. In addition to the webinar, you can also learn more about Let's Go Learn by visiting, letsgolearn.com.



The Healthy Student's, Promising Futures Collaborative

On April 3, 2020, The Healthy Student's, Promising Futures Collaborative held a conference call on what states are doing around the delivery of school health services during the COVID-19 Pandemic.  To view the resources that were shared, click on the link below:

Resources Shared on April 3 COVID Call


COVID-19 FAQ's, please reference pages 17 & 18 regarding Random Moment Time Study guidance. Click Here.  



CMS Disaster Response Toolkit

Medicaid, Children’s Health Insurance Program, and Basic Health Program services provide critical health coverage to millions of vulnerable Americans. Over the past several years, numerous states have been impacted by natural or man-made disasters, and these programs serve an important role as states respond to these disasters. Click below to access the site:



CMS Issues SHO on Mental Health Coverage Requirements in Standalone CHIP Programs

On March 2, the Centers for Medicare and Medicaid Services (CMS) published a State Health Official letter describing required access to mental health and substance use disorder services for children and pregnant women enrolled in standalone CHIP programs, as required under Section 5022 of the SUPPORT Act.

These provisions, which became effective October 24, 2019, require child health and pregnancy related assistance to cover mental health services and behavioral health services necessary to prevent, diagnose, and treat a broad range of mental health symptoms and disorders. CMS interprets the coverage requirements to include all developmental and behavioral health related screenings and preventive services recommended by the American Academy of Pediatrics' Bright Futures periodicity schedule and any services with a grade of A or B under the U.S. Preventive Services Task Force. CMS also provides a set of validated behavioral health screening tools that would satisfy the screening requirement. 

Lastly, in order to meet the statutory implementation deadline of October 24, 2019, CMS indicates that states needing to make changes to a standalone CHIP program must file a CHIP State Plan Amendment no later than the end of the state fiscal year that includes that date.

National Alliance for Medicaid in Education, Inc. (NAME)

"We envision the day when public policy values children's health as essential to learning."

The National Alliance for Medicaid in Education, Inc. (NAME) is a non-profit 501(c)(3) organization that was created in response to a need for a national forum to address the complexities and challenges of Medicaid reimbursement programs in school settings.

NAME facilitates a member network comprised mostly of volunteers to share information about Medicaid in Education, and is the only organization of its kind. NAME's membership is primarily composed of professionals from the nation's public school districts, state Medicaid agencies and state education agencies who are involved in administration of Medicaid claiming for school-based services. Other members are those with an interest in the Medicaid in Education field such as businesses, consulting firms, non-profit organizations and federal agencies.

NAME collaborates with key Federal agencies: the Centers for Medicare & Medicaid Services (CMS), the Office of Special Education Programs (OSEP), and other partners and stakeholders, to develop and support public policies that value children's health and recognize it as essential to learning.



Our Membership

NAME draws on the expertise of highly informed and specialized sources from around the country at federal, state and local levels, as well as the private sector.

NAME has two categories of members:

Voting Members are individuals employed or contracted by a state Medicaid agency, state education agency or local education agency who have responsibility for administering the Medicaid administrative claiming or direct billing of school-based health related special education or free care services provided by public schools to students.

Associate Members are non-voting and include individuals from an agency/organization or company that provides services/support for school-based health care, special education or Medicaid in Education, or function as a Medicaid billing agent.


NAME's Strategic Partners

School-Based Health Alliance Provides:

Hallways to Health: Creating a School-Wide Culture of Wellness

Wellness is determined in great part by where children live, learn, and grow. Recognizing this, schools across the country are collaborating to create a culture of wellness that extends beyond the health clinic walls into school hallways, classrooms, cafeteria, teachers’ lounges and campus spaces.


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Through Medicaid claiming for covered health-related services and Medicaid-related administrative activities, public schools receive reimbursement for some of their costs for serving Medicaid-eligible school-age children.