School-Based Services

Set against the backdrop of rising concern about the mental health of young people, various strategies have been introduced recently to enhance access to behavioral health care, particularly through the expansion of school-based services (SBS) for students. These services can facilitate improved access to care and enable the early detection and treatment of mental health challenges.

Nevertheless, obstacles remain. Inadequate funding and workforce shortages frequently impede the effective implementation and long-term sustainability of these initiatives.

Additionally, CMS guidance revises the qualifications required for providers. Medicaid may cover various health services for children in schools, including health screenings, speech or physical therapy for students with disabilities, and a range of medically necessary physical, mental health, and substance use disorder services.

Specific behavioral health services covered include psychological testing and evaluation, individual and group therapy, and crisis intervention services. While the guidance does not expand the list of covered services, it clarifies existing coverage and offers recommendations for schools to deliver these services more effectively under Medicaid. Furthermore, it encourages collaboration between state Medicaid agencies, state education agencies, and schools to promote the provision of SBS and highlights opportunities for technical assistance.

Key Auditing Services

School-based services are essential for underserved children, providing Medicaid-covered therapies, case management, and transportation directly in schools. However, compliance challenges—such as incorrect coding, lack of documentation, and audit findings—can threaten funding and service continuity. Myers and Stauffer partners with state Medicaid agencies to provide expert audit, compliance, and cost reporting services, ensuring program integrity and maximizing allowable reimbursement. With decades of experience and a commitment to independence, we provide audit services to help states navigate these complexities, ensuring accurate cost reporting, compliance, and optimal reimbursement.

Key Consulting Services

Medicaid-funded school-based services are essential for underserved children, but compliance challenges can put funding at risk. Incorrect coding, missing documentation, and audit findings can lead to disruptions and potential repayment obligations. Myers and Stauffer offers consulting services to assist states in navigating these challenges, ensuring accurate cost reporting, compliance, and maximizing reimbursement opportunities.

How Myers and Stauffer Can Help

Given the regulatory and logistical complexity of the problems states face, as well as the proposed solutions driven by updated CMS guidance, finding a way forward can be daunting.

Myers and Stauffer has significant experience and expertise in providing SBS Medicaid consulting, financing, and operations support to state agencies. Our work has focused on supporting Medicaid agencies as they partner with school districts and state education agencies to maximize their funding, optimize operations, and improve health outcomes for students. Our skilled work in this area covers a range of services, including Medicaid billing, program design enhancement, data analytics, and program integrity compliance.