School-based Medicaid Claiming

Program helped states reclaim $750 million

Title XIX of the Social Security Act specifies that the delivery of direct medical services to Medicaid-eligible students with special needs, along with associated administrative activities, qualify for federal reimbursement. This affords states the opportunity to increase their revenue sources and establish an effective, sustainable program.     

Since establishing a school-based claiming team to develop, implement and manage programs in this area more than a decade ago, UMass Medical School’s Center for Health Care Financing has helped local governments in multiple states secure approximately $750 million in federal reimbursement.

The Center developed an advanced web-enabled application that allows Medicaid providers to complete time studies, document the delivery of health-related services or submit claims electronically.

• Medicaid Claiming
  By maximizing revenue, the Center reduces the administrative burden for school district staff.
• Local Initiatives
  The Center applies the best practices in school-based claiming in several other state and local agencies.
• Statewide Program Development
  The Center's designs and implements claiming programs that are customized to the needs of individual states.