Kentucky school districts may participate in two Medicaid School-Based Programs. School-Based Health Services and School-Based Administrative Claiming.
School-Based Health Services (SBHS)
The School-Based Health Services (SBHS) program authorizes local education agencies in Kentucky, including KSB and KSD to enroll as a Medicaid Health service provider for children who are eligible under the Medicaid program and under the Individuals with Disabilities Education Act(IDEA). The Medicaid SBHS program is designed specifically to allow school districts to act as health care providers and be reimbursed under Medicaid. School districts may be reimbursed approximately 70 percent of the state and local funds they spend on some related services in the individualized education programs (IEP) of children with disabilities who are eligible under both IDEA and Medicaid.
SBHS Technical Assistance Guide March 2019
Parental Consent and Annual Notification Letters
Spanish version of Parental Consent and Annual Notification Letters.
Parental Consent and Annual Notification Letters--Spanish
The brochure below can be printed and shared with parents during registration or by the FRYSCs.
SBHS Parental Consent Brochure
This FAQ document should address the concerns regarding Medical Necessity in the IEP and the Transportation issues.
The School-Based Health Services application must be submitted annually. The Department for Medicaid Services will not honor any claims until the application has been approved by KDE.
SBHS Practitioner Qualifications and Modifiers
Amending the Application
The amendment form must be submitted to make changes to the approved practitioner list. The form adds staff or deletes staff and services to the district's approved application.
Release of Information *Coming Soon*(forms must be signed annually by parents of Medicaid eligible students.)
KDE Medicaid Monitoring Procedures *Coming Soon*
KDE Monitoring Audit Review Tool *Coming Soon*
School-Based Administrative Claiming (SBAC)
The Medicaid School-based Administrative Claiming (SBAC) program reimburse school districts for the time employees spend in administrative activities that directly support efforts to identify and enroll potentially eligible children and their families into Medicaid. SBAC involves all school district staff who, as part of their routine job duties, help students and their families learn about Medicaid, apply for Medicaid benefits, refer students to community medical and mental health providers or collaborate with other school staff or community agencies to better address the health care needs of students.
School Based Administrative Claiming Technical Assistance Document approved by CMS
MUNIS Support and Guides Website