Quick Facts

• Public Health Emergency (PHE) will expire on 5/11/2023.
• Continuous coverage requirement ends as of 4/1/2023.
• Medicaid redeterminations begin on 4/1/2023.
• Redetermination timelines will vary by state. See map for details.
• Enhanced Federal Medical Assistance Percentage (FMAP) will begin to phase out, and fully expires 1/1/2024.
• It is estimated that between 5 – 14 million people could lose their Medicaid coverage.
• A reduced Medicaid eligibility rate will impact school-based Medicaid claiming reimbursements.
• Medicaid outreach is reimbursable via Medicaid Administrative Claiming (MAC) programs, as activities will be captured in Random Moment Time Study (RMTS), for LEAs that participate in MAC.

Read more: PHE Unwinding - LEA Quick Reference Guide

The bipartisan Safer Communities Act that passed to prevent gun violence last week included language requiring CMS to issue new school-based Medicaid guidance before June 2023. The guidance does EXACTLY what we have been asking CMS to do for years and even does more than what we had hoped for in that it provides direct grants to states to start the hard, but meaningful work of changing how they process Medicaid claims, find ways to dramatically expand Medicaid-reimbursable services to schools, and generally take advantage of the new flexibilities that they will be granted via updated guidance to expand healthcare, particularly mental health services, to millions more children.

For resources to help organizations address the youth mental health crisis, check out the most recent Campaign Notes eNewsletter from CMS and the Connecting Kids to Coverage National Campaign:

https://www.insurekidsnow.gov/newsletter/2022/05/26/index.html. 

Districts across the country are using federal COVID relief aid to bring mental health professionals into schools. But this unprecedented infusion of federal aid also creates a challenge: how to sustain new school staff positions when the funding expires at the end of 2024.