Hillsborough school staff brief board on Medicaid changes; finance to start internal rate study

Hillsborough County Public Schools staff told the school board at a board-requested Medicaid workshop that the district runs two distinct school-based Medicaid programs, faces pending federal guidance and state-level requirements that could change how districts are reimbursed, and that finance will begin an internal rate study next week to seek higher reimbursement rates.

The presentation, led by Chief Financial Officer Jamie Lewis and Medicaid specialist Deneen Grisani, described (1) the district's administrative claiming program, known as School District Administrative Claiming (SDAC) or random moment time sampling (RMTS); (2) the fee-for-service program for direct student services; (3) compliance issues tied to certification of public expenditures (CPE); and (4) planned district actions, including a rate study and stepped-up outreach with community partners to increase student enrollment in Medicaid and CHIP.

Why it matters: Federal guidance issued in May 2023 and related requirements must be implemented by July 1, 2026, according to the presentation. That guidance shifts the way school-based Medicaid may be paid in some cases from a historical fee schedule to reimbursement based on documented expenditures, a change that requires a state plan amendment (SPA) and additional state rulemaking. District…