Proposed rules would let Alaska schools bill Medicaid for any eligible student

The Alaska Department of Health proposed rules Sept. 15 that would let school districts bill Medicaid for any Medicaid-eligible student, not only children with a disability and an individualized education program, or IEP. A supplemental notice moved the public hearing to Oct. 26 and pushed the comment deadline to Nov. 6.

The rules carry out HB 344, which became law without the governor's signature Aug. 30, 2024. When the bill passed, six of the state's 54 school districts billed Medicaid, reaching about 2,100 of the state's 93,772 school-age Medicaid recipients, according to a 2024 department fiscal note. The department expected about half of districts to take part eventually.

Under current rules, the state pays only for services tied to a student's IEP, plus evaluations or screenings that show a need for one. The proposed rules would also cover services a treatment plan calls medically necessary, along with screenings and medication management. Covered care would include physical, occupational and speech therapy, hearing services, behavioral health and nurse medication services.

Districts would need documented parental consent before billing, and teachers couldn't serve as the billing clinician. Payment would be capped at 85% of the standard rate, and a district and a private provider couldn't both bill for the same in-school service on the same day.

The department expects no increase in Medicaid costs, because the services are already available to Medicaid-eligible students. The change is "a shifting of the mode these services can be provided," a department fiscal note said.

The hearing will be held by Zoom. A separate federal plan amendment for the change, posted Oct. 1, would take effect Jan. 1, 2027, with comments due Oct. 30.