Bill Text: VA SB1354 | 2025 | Regular Session | Introduced
Bill Title: Medicaid billing navigator positions; established.
Spectrum: Partisan Bill (Democrat 2-0)
Status: (Introduced) 2025-01-28 - Reported from Education and Health and rereferred to Finance and Appropriations (15-Y 0-N) [SB1354 Detail]
Download: Virginia-2025-SB1354-Introduced.html
2025 SESSION
INTRODUCED
25102991D
SENATE BILL NO. 1354
Offered January 13, 2025
Prefiled January 13, 2025
A BILL to amend the Code of Virginia by adding a section numbered 22.1-23.6, relating to Department of Education; Medicaid billing navigator positions; report.
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Patron—Srinivasan
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Referred to Committee on Education and Health
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Be it enacted by the General Assembly of Virginia:
1. That the Code of Virginia is amended by adding a section numbered 22.1-23.6 as follows:
§ 22.1-23.6. Medicaid billing navigator positions.
A. In order to provide school divisions with guidance and assistance to effectively navigate the laws, policies, rules, regulations, and guidelines governing Medicaid billing for reimbursable services rendered at school sites, including P.L. 117-159, and to ensure that all school divisions are able to fully leverage Medicaid funding opportunities to enhance student health services, the Superintendent shall establish within the Department two Medicaid billing navigator positions. Each Medicaid billing navigator shall possess expertise in Medicaid billing processes, with a particular emphasis on school-based services and federal health care regulations. Preferred qualifications for each position shall include experience working with school divisions, health care billing, or federal Medicaid compliance.
B. Each Medicaid billing navigator shall coordinate with the Department of Medical Assistance Services to assist each school division in:
1. Understanding and navigating the current federal Medicaid billing and reimbursement processes and procedures;
2. Training school division staff on the billing and reimbursement processes and procedures for Medicaid-reimbursable services provided directly by school personnel or contracted providers at school sites;
3. Identifying new services that are eligible for Medicaid reimbursement under any expansion of eligibility pursuant to state or federal law, policy, rule, regulation, or guidelines;
4. Ensuring compliance with both state and federal Medicaid billing requirements; and
5. Developing best practices and documentation templates to streamline the school division's Medicaid billing process.
C. In addition to the duties set forth in subsection B, each Medicaid billing navigator shall coordinate with the Department of Medical Assistance Services to provide direct support to school divisions through:
1. Conducting training sessions and workshops for school administrators and financial officers to familiarize such individuals with any new Medicaid billing opportunities;
2. Assisting school divisions in submitting claims for Medicaid-reimbursable services, including mental health services, physical and occupational therapy, speech and language pathology, and other reimbursable health-related services provided to students at school sites;
3. Advising school divisions on strategies to expand Medicaid-reimbursable services based on student needs and available resources; and
4. Creating and distributing guidance documents, toolkits, and other resources to ensure consistency in Medicaid billing practices in school divisions across the Commonwealth.
D. Each Medicaid billing navigator shall work collaboratively with the Department of Medical Assistance Services to ensure alignment of school division Medicaid billing practices with state Medicaid requirements.
E. The Department shall include the costs associated with each Medicaid billing navigator in its annual budget request and such positions may be funded with general fund dollars or any federal grants or reimbursements available for Medicaid-related administrative services.
F. The Medicaid billing navigators shall report by December 31 of each year to the Secretary of Education, the Superintendent, and the Chairmen of the House Committee on Education and the Senate Committee on Education and Health on:
1. The number of school divisions utilizing Medicaid billing services;
2. The amount of Medicaid funds reimbursed to school divisions for services rendered, disaggregated by school division; and
3. Recommendations for improving or expanding Medicaid billing practices in school divisions across the Commonwealth.
G. Nothing in this section shall be construed to preclude or discourage school boards from employing or contracting for the services of individuals to coordinate at the school division level Medicaid billing for reimbursable services rendered at school sites or to perform similar or related functions.
