About School-based Medi-Cal
In 1989, Congress enabled school districts to claim federal funds for health related services they provide to students enrolled in Medicaid. Districts can seek reimbursement from Medicaid for these services as long as the district is a Medicaid provider and meets requirements regarding licensure, certification, and other federal mandates for the Medicaid program.
Another federal law, the Individuals with Disabilities Education Improvement Act commonly known as IDEA, authorizes federal reimbursement for health related services specified in a Medicaid-eligible child’s IEP.
Medicaid is called Medi-Cal in California. California established its Local Education Agency (LEA) Billing Option Program in 1993 and it’s Medical Administrative Activities Program (MAA) in 1994.
In LAUSD, these two distinct Medi-Cal programs have the responsibility to recover costs from the federal government to offset the expenses of existing programs and to fund supplemental health and human services:
- Local Education Agency Medi-Cal Billing Option Program
The Local Education Agency Medi-Cal Billing Option (LEA) is a fee-for-service program which includes direct assessment and services to Medi-Cal eligible children. Claims which capture this direct service are processed using the information entered by providers in the Welligent Service Tracking System (STS). For more information about the Medi-Cal Billing Option Program and the LEA Collaborative click here.
- Medi-Cal Administrative Activities (MAA) Program
California established its Medi-Cal Administrative Activities Program (MAA) in 1994. MAA claims are reimbursement for indirect administrative activities. The District is required to conduct a quarterly Time Survey which is completed by District MAA participants in Welligent. For more information about MAA, including training and support documentation click here.