The Centers for Medicare and Medicaid Services (CMS) has clarified its "free care" rule, which should make it easier for school-based sealant programs to receive Medicaid reimbursement, according to a letter dated from CMS Director Cindy Mann.
"The goal of this new guidance is to facilitate and improve access to quality healthcare services and improve the health of communities," Mann wrote.
The previous guidance from CMS caused some confusion, as some states interpreted the rule as preventing a sealant program from billing Medicaid for services unless the program billed all children receiving services -- regardless of their source of payment or insurance status. CMS clarified that Medicaid will allow reimbursement for covered services "regardless of whether there is any charge for the service to the beneficiary or the community at large." The guidance has the potential to provide sealant programs with revenue and improve their sustainability.
