Medi-Cal Reimbursement and Compliance Programs

About School Medi-Cal Programs

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. School Medicaid programs are administered by the federal Centers for Medicare and Medicaid (CMS) and the California Department of Health Care Services (DHCS).

Medicaid is called Medi-Cal in California. California established its Local Education Agency (LEA) Medi-Cal Billing Option Program in 1993 and its Medi-Cal Administrative Activities (MAA) Program in 1994.

The DUSD Student Support Services office operates both programs and has 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 (LEA) Medi-Cal Billing Option Program

The Local Education Agency (LEA) Medi-Cal Billing Option program is a fee-for-service program which includes direct assessment and services to Medi-Cal eligible students who are enrolled in Special Education and have an Individualized Education Plan (IEP) for certain services.

Learn more about the LEA Medi-Cal Billing Option Program and the LEA Collaborative Board

School-Based Medi-Cal Administrative Activities (SMAA)

The SMAA program reimburses school districts for the federal share (50%) of the certain costs for administering the Medi-Cal program. Those activities include: Outreach and Referral; Facilitating the Medi-Cal Application; Arranging Non-Emergency/Non-Medical Transportation; Program Planning and Policy Development; and MAA Claims Coordination.

Learn more about the School-Based Medi-Cal Administrative Activities (SMAA)

Click here for Frequently Asked Questions (FAQs)