New Law Includes ASHA Medicaid Priorities

President Biden recently signed into law the Bipartisan Safer Communities Act, legislation designed to reduce gun violence. The law [PDF] also includes several Medicaid related policies aligned with priorities in ASHA’s Public Policy Agenda, which ASHA and its members have advocated for. These priorities focus on streamlining access to services provided by audiologists and SLPs and facilitating reimbursement for those services, particularly when delivered in schools.

Early and Periodic Screening, Diagnosis, and Treatment

The law includes several provisions to improve state implementation of Medicaid’s Early and Periodic Screening, Diagnosis, and Treatment (EPSDT) benefit.

Specifically, the law:

• Requires states to improve reporting of, and compliance with, the federal EPSDT mandate, which requires coverage of certain health care services for children under age 21, including speech and audiology services, to ensure its enforcement;
• Clarifies that states should take steps to allow and encourage a school district to bill for any EPSDT service provided, including additional financial support; and
• Requires the development of a comprehensive list of approved methods that jurisdictions have used to pay for and increase the availability of EPSDT services in schools, creating resources for new districts, and/or those needing assistance with Medicaid billing.

Telehealth

The law requires the U.S. Department of Health and Human Services (HHS) to provide technical assistance and issue guidance to states on improving access to telehealth for services covered under Medicaid and the State Children’s Health Insurance Program (CHIP).

Specifically, the law:

• Requires strategies to promote the delivery of accessible and culturally competent care via telehealth, including addressing the needs of individuals with disabilities, members of medically underserved populations, racial and ethnic minorities, and individuals with limited English proficiency;
• Emphasizes training and provides resources to providers and patients on the use of telehealth, including working with interpreters to furnish health care services and providing resources in multiple languages; and
• Encourages best practices to support the delivery of covered services under Medicaid and CHIP via telehealth in schools.

School-Based Medicaid Billing

The law includes several provisions to reduce administrative burdens and simplify billing to make it easier for school-based providers, such as audiologists and SLPs, to receive reimbursement for Medicaid services provided in schools.

Specifically, the law:

• Requires the Centers for Medicare & Medicaid Services (CMS) to update old and confusing guidance to help clarify policies and procedures for school-based Medicaid billing;
• Creates a new $8 million technical assistance (TA) center within the U.S. Department Health and Human Services, in consultation with the U.S. Department of Education, to directly answer questions from local jurisdictions about how to access school-based Medicaid funding;
• Requires the TA center to direct assistance to implement best practices for practitioners and students to make it easier for schools and families to access high quality school-based Medicaid services; and
• Provides $50 million in grants to states to expand assistance to school-based entities under Medicaid or CHIP.

What’s Next?

ASHA will provide input on these provisions to the Departments of Health and Human Services and Education to ensure effective and efficient implementation for the benefit of ASHA’s members and those they serve and urge Congress to provide comprehensive coverage and equitable payment for audiology and speech-language pathology services. Audiologists and SLPs can help support efforts to establish a TA center on communication/speech disorders within the Department of Education by taking action now.

Questions?

Contact Jerry White, ASHA's director of federal and political affairs, at jwhite@asha.org.