Bill to expand school-based Medicaid billing, training for nurses draws broad support

Representative Riley presented House Bill 583 to the Medicaid Oversight Board, saying the measure would expand school-based Medicaid billing so schools can seek reimbursement for medically necessary services they already provide to Medicaid-enrolled students (with parental consent) beyond those tied to IEPs or 504 plans. Riley argued the bill would enable schools to recoup federal Medicaid dollars by documenting existing services and by using those school salaries and administrative costs as the state match for federal funds.

Gannon Tager of the Kentucky Nurses Association School Nurse Committee and Emily Beauregard of Kentucky Voices for Health testified in support. Tager said school nurses identify health and mental-health needs and that research shows school nurses reduce absenteeism and improve educational outcomes. Beauregard said roughly half of Kentucky students are covered by Medicaid or KCHIP and that about 40% of schools still lack a full-time nurse; she estimated the state would need roughly 600 more mental-health providers to meet a 1-to-250 student ratio goal. Beauregard told the board that onboarding and training for school staff and Medicaid technical assistance would cost the state about $111,000 a year.

Commissioner Lisa Lee later told the board DMS submitted an updated state plan amendment to CMS to align Kentucky’s school-based services language with 2023 CMS guidance; she described the SPA as administrative, saying it does not expand eligibility or benefits but clarifies which provider types may bill and which services are included in cost settlement for schools.

Board members asked practical questions about billing mechanics, whether third-party billers would be used (most schools do), which provider types are covered (APRN, RN, LPN, counselors and others), data sharing with primary care (some schools use Infinite Campus or other EHRs; practices vary), and whether services cover acute and chronic conditions (testimony said yes, within schools’ staff capabilities). The session included repeated assertions that this approach would not add state general fund costs beyond training and that schools would supply the state match via existing salaries and administrative budgets.