The low incoming students would now be billed for Medicaid for services of health like screening of asthma and care for chronic diseases by their schools after occurrence of unexpected federal policy reversal.

School had no rights for asking Medicaid to pay for services if they gave the public free services, “free care rule” Children with disability were given some exceptions.

All the children were being charged for the given services by the Districts which overweighed low incoming family not enrolled in Medicaid.

The rule was brought down in 2004 by the department of health and human services appeals board. This could be beneficial to lower income districts.  California rejected the policy by 2013.

The “free care rule” was reversed by CMS previous December, though it would take years or months for more health services to be offered by districts. Given states don’t allow schools to be reimbursed by Medicaid.

Districts could circumvent the rule by charging all children for the services. That approach, however, placed a burden on low-income families not enrolled in Medicaid who may not be able to afford even nominal fees.

“It does sound very wonky, but it certainly has a big impact on students and schools across the country,” Malcarney told Reuters Health. “Because of the rule, schools shied away from offering many services. It also impacted the ability of low-income schools to hire health care staff, because they could not receive funding from Medicaid.”

In 2004, the Department of Health and Human Services Departmental Appeals Board struck down the rule, concluding that it had no basis in federal law. In 2013, a California court also rejected the policy. But the issue remained cloudy.

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