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SENATE DOCKET, NO. 1871 FILED ON: 1/20/2023
SENATE . . . . . . . . . . . . . . No. 794
The Commonwealth of Massachusetts
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PRESENTED BY:
Susan L. Moran
_________________
To the Honorable Senate and House of Representatives of the Commonwealth of Massachusetts in General
Court assembled:
The undersigned legislators and/or citizens respectfully petition for the adoption of the accompanying bill:
An Act relative to MassHealth reimbursement for schools.
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PETITION OF:
NAME:DISTRICT/ADDRESS :Susan L. MoranPlymouth and BarnstableMathew J. Muratore1st Plymouth2/2/2023Michael O. MooreSecond Worcester2/15/2023David Paul Linsky5th Middlesex3/6/2023 1 of 4
SENATE DOCKET, NO. 1871 FILED ON: 1/20/2023
SENATE . . . . . . . . . . . . . . No. 794
By Ms. Moran, a petition (accompanied by bill, Senate, No. 794) of Susan L. Moran, Mathew J.
Muratore, Michael O. Moore and David Paul Linsky for legislation relative to MassHealth
reimbursement for schools. Health Care Financing.
The Commonwealth of Massachusetts
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In the One Hundred and Ninety-Third General Court
(2023-2024)
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An Act relative to MassHealth reimbursement for schools.
Be it enacted by the Senate and House of Representatives in General Court assembled, and by the authority
of the same, as follows:
1 SECTION 1. Section 72 of chapter 44 of the General Laws, as appearing in the 2020
2Official Edition, is hereby amended by striking, in line 8, the words “local government entity”
3inserting in place thereof the following:- “local educational authority.”
4 SECTION 2. Said section 72 of chapter 44 of the General Laws, as so appearing, is
5hereby further amended by striking, in line 10, the words “local government entity” inserting in
6place thereof the following:- “local educational authority.”
7 SECTION 3. Said section 72 of chapter 44 of the General Laws, as so appearing, is
8hereby further amended by striking, in line 13, the words “local government entity” inserting in
9place thereof the following; “local educational authority.”
10 SECTION 4. Said section 72 of chapter 44 of the General Laws, as so appearing, is
11hereby further amended by striking the words “Any funds received by a local government entity
12pursuant to the provisions of this section shall be considered unrestricted revenue of the local 2 of 4
13government entity and may be spent in accordance with any general or special law governing the
14expenditure of the entity's revenues.” and inserting in place thereof the following:- “A local
15educational agency which obtains MassHealth reimbursement for providing school-based
16services, administrative activities or any other medical benefits to a school-age child under this
17chapter, by and through its employees and agents, shall maintain the proceeds of such
18reimbursement to fund school-based services and related administrative activities at any school
19facility or school system which it operates or over which it has direct supervision or jurisdiction.
20Said proceeds should not supplant existing or planned school health funding.”
21 SECTION 5. Chapter 71 of the General Laws is hereby amended by inserting after
22Section 98 the following section:-
23 Section 99. (a) For the purposes of this section, the following words shall have the
24following meanings:
25 “Administrative activities”, those activities as defined in the local educational agency’s
26provider contract with MassHealth.
27 “Local educational agency”, any city, town, charter school, public health commission, or
28school district.
29 “Individualized education program”, a written statement, developed and approved in
30accordance with federal special education law in a form established by the department of
31elementary and secondary education of the Commonwealth that identifies a student's special
32education needs and describes the services a local educational agency shall provide to meet those
33needs. 3 of 4
34 “School-age child”, any person of ages three through twenty-two who has not attained a
35high school diploma or its equivalent.
36 “School-based Medicaid provider”, any local educational agency that provides School
37Based Services to Members and performs administrative activities on behalf of the executive
38office of health and human services pursuant to their provider contract with MassHealth.
39 “School-based services”, any medically necessary MassHealth covered services, as
40delineated in the Medicaid State Plan, which are provided to a member by a school-based
41Medicaid provider.
42 “School personnel”, a School-Based Medicaid Provider’s salaried and/or contract staff
43operating under a contractual agreement with the School-Based Medicaid Provider. School
44Personnel include, but are not limited to, nurses, therapists, special education administrators,
45psychologists, social workers, school counselors, and clerical support.
46 (b) The executive office of health and human services together with the executive office
47of education shall ensure that each local educational agency enrolled with the division as a
48MassHealth provider shall implement a plan to obtain MassHealth reimbursement of school-
49based services, administrative activities and any other medical benefits provided by such local
50educational agency to any school-age child who is an eligible beneficiary of MassHealth in
51accordance with this chapter, Title XIX and Title XXI as appropriate.
52 (c) Notwithstanding any other law or regulation to the contrary, any local educational
53agency enrolled with the division as a MassHealth provider of school-based services,
54administrative activities and any other medical benefits shall be entitled to submit claims to
55MassHealth for reimbursement for providing, by and through its employees or agents, such 4 of 4
56services and medical benefits to any school-age child who is an eligible beneficiary. Any school-
57based services, administrative activities or other medical benefits provided by a local educational
58agency to a school-age child who is an eligible beneficiary under this chapter shall be
59reimbursable by MassHealth regardless of whether said school-age child participates in an
60individualized education program, an individual health care plan, or a plan under Section 504 of
61the Rehabilitation Act of 1973, or whether said school-based services, administrative activities or
62other medical benefits are provided at no charge to any school-age child who is not an eligible
63beneficiary.
64 (d) A local educational agency which obtains MassHealth reimbursement for providing
65school-based services, administrative activities or any other medical benefits to a school-age
66child under this chapter, by and through its employees and agents, shall maintain the proceeds of
67such reimbursement to fund school-based services and related administrative activities at any
68school facility or school system which it operates or over which it has direct supervision or
69jurisdiction. Said proceeds should not supplant existing or planned school health funding, and
70shall be used for such purposes including, without limitation, school-based services and other
71school health programming, which may include enhanced capacity to provide comprehensive
72behavioral health support, case management, health education, social emotional learning and
73health support, outreach and enrollment, school health infrastructure development, and other
74related school health services.