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House approves bill to let schools seek Medicaid reimbursement for in-school mental-health services
Summary
The Utah House passed a bill allowing Medicaid reimbursement for mental-health services provided in schools and preventing insurers from denying claims solely because services are delivered on school property. Sponsors say it helps students get care without creating network mandates for health plans.
SALT LAKE CITY — The Utah House on Feb. 27 passed first substitute Senate Bill 106, a measure to let schools seek Medicaid reimbursement for mental-health services and to restrict insurers from denying coverage because a service occurred on school grounds.
Representative Brady Pulsipher, the House sponsor, told members schools already bill Medicaid for services such as physical and occupational therapy but lack an explicit mechanism to bill for mental-health services performed in schools as part of individualized education programs. "This bill directs the state health department to submit a plan so we can begin reimbursing schools for these mental-health services," Pulsipher said during floor remarks.
Representative Thurston pressed the sponsor in a series of questions about practical effects for students not enrolled in Medicaid and whether the bill would require health plans to add school-based providers to their networks. Pulsipher replied that while claims could be submitted for non-Medicaid children, insurers cannot deny those claims solely because the services took place in a school; the bill does not force plans to add school providers to their networks. "If the school chose, they could go and become a preferred provider," Pulsipher said, adding that the bill "does not require them to change anything that's already in existence."
Lawmakers framed the change as a way to address a pressing need for mental-health services delivered in schools and to align billing rules with existing school service delivery. The House approved the measure 66-4; first substitute SB106 will be signed by the Speaker and returned to the Senate for further consideration.
The next procedural step is the Senate signature and any required administrative action by the Utah Department of Health to file necessary Medicaid plan amendments. The bill sponsor said the department will be asked to develop the reimbursement plan and guidance to school districts and providers.
