Gopal, Ruiz Bill Requiring Medicaid Reimbursement for Covered Behavioral Health Services Passes Senate

TRENTON – The full Senate approved legislation sponsored by Senator Vin Gopal and Senate Majority Leader M. Teresa Ruiz that would require Medicaid reimbursement for covered behavioral health services provided by a local education agency to any student who is eligible as a Medicaid beneficiary.

Under the bill, Medicaid-covered behavioral health services provided to a Medicaid beneficiary would be reimbursable regardless of whether the student participates in an Individualized Education Program (IEP), 504 Accommodation Plan, Individualized Health Care Plan (IFSP), or Individualized Family Service Plan; or whether the covered services are provided at no charge to the student.

The bill would require such services to be provided by a licensed medical practitioner approved as a Medicaid provider or a local education agency approved as a Medicaid provider.

“All New Jersey students in need of behavioral health services or treatment should have access to them. This bill allows us to build out school-based Medicaid services at a time when many students and their families are facing behavioral health challenges,” said Senator Gopal (D-Monmouth), chair of the Senate Education Committee. “This will also allow a school to access additional funds through which it can improve and expand these services to its students.”

The legislation comes in response to the reversal of a federal Medicaid policy which prohibited Medicaid reimbursement for school health services if the same services were provided free of charge to the general student population unless the services were specifically included in a student’s IEP, IFSP, or other similar educational plan.

“The pandemic and the isolation it brought exacerbated issues of mental health amongst our students. This will help to expand the availability of mental health services within our schools by extending coverage to all Medicaid recipients at no cost to the district or the parents. It is critical as we rebound from the pandemic that we continue to look for ways to better support our students socially, emotionally and academically,” said Senator Ruiz (D-Essex).

Currently, Medicaid reimbursement is only available in New Jersey for those services provided to students who qualify under the rule exception through the Special Education Medicaid Initiative (SEMI) program.

The bill, S-2416, was released by a vote of 36-0.