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DMAS outlines school‑based Medicaid expansion approved by CMS and describes Medicaid coordinator role
Summary
DMAS senior policy analyst Lynn Hamner explained a CMS‑approved state plan amendment (Sept. 2023) that expanded school‑based Medicaid services to all eligible Medicaid students, described the random moment time study reimbursement method and detailed the Medicaid coordinator’s monitoring, documentation and training responsibilities.
Dorothy Swan introduced Lynn Hamner, a senior policy analyst at the Department of Medical Assistance Services (DMAS), who briefed stakeholders on school‑based Medicaid services and the role of the Medicaid coordinator.
Lynn Hamner said DMAS passed a state plan amendment that was approved by the Centers for Medicare & Medicaid Services in September 2023 which expanded eligibility for school‑based Medicaid services beyond students with individualized education programs to all eligible Medicaid students. "The main change was that in the past, only students, Medicaid students with an IEP ... were able to access these services, but now all eligible Medicaid students can receive those services," Hamner said, and she added that the amendment expanded some mental‑health and nursing screening services.
Hamner described the reimbursement method for school services, explaining the random moment time study (RMTS) used to estimate staff time devoted to medical versus educational activities. Staff complete periodic RMTS moments to classify activities, and those responses feed into reimbursement percentages and the annual cost report.
The presentation detailed the many responsibilities of school Medicaid coordinators: organizing RMTS participation, matching eligibility lists to student rosters, preparing annual cost reports, monitoring billing completeness and accuracy, training staff on documentation and administrative compliance, and maintaining records for DMAS audit reviews. Hamner said coordinators attend quarterly Medicaid coordinator meetings and receive multi‑day one‑on‑one trainings; she mentioned a sequence of training days completed for coordinators.
During Q&A staff suggested participants with eligibility questions (for example, a question that raised IDEA program age limits) follow up with DMAS eligibility staff; Dorothy asked the participant to send the question by email so subject matter experts could reply.
Hamner closed by noting daily collaboration with the Virginia Department of Education in implementing school‑based services.
