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Health Services The Medicaid School-Based Administrative Claiming (SBAC) Program

The Division of Medicaid, the Mississippi Department of Education, and individual schools share in the responsibility for promoting access to health care for students in the public school system, preventing costly or long-term health care problems for at-risk students, and coordinating students’ health care needs with other providers.  Many of the administrative and some other activities within the school health-related services program, and performed by the school staff, meet the criteria for Medicaid administrative claiming.

The Medicaid School-Based Administrative Claiming (SBAC) program is a federally funded program administered by the Division of Medicaid in coordination with the Department of Education.  The program allows school districts to be reimbursed for some of their costs associated with school-based health and outreach activities which are not claimable under the Medicaid School Health-Related Services “fee for service” program or under other Medicaid “fee-for-service” programs.

Although documentation is required under the SBAC program, these requirements are unlike the “fee-for-service” programs.  Under the SBAC program, it is necessary to determine the amount of time school staff spend performing Medicaid administrative activities.  This is captured through the use of time samples.  The results of time samples are then used in a series of calculations to determine the percentage of the SBAC school districts’ costs that can be claimed under SBAC.  SBAC reimbursement to school districts is made from federal Medicaid funds.

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