In November 2023, California Governor Gavin Newsom signed Assembly Bill AB 483, paving the way for California schools to participate more easily in California’s Local Education Agency Billing Option Program (LEA BOP). The primary goal of AB 483 is to enhance the accessibility of federal Medicaid reimbursement funds for school-based mental health and health services provided to Medi-Cal students.
California Schools Have Been Reluctant to Use Medi-Cal Billing
According to the CA Assembly AB 483 Fact Sheet, the “current Medi-Cal LEA BOP is administratively burdensome, due to extensive documentation requirements, and punitive audit practices.” California schools have struggled with Medi-Cal audit practices in the past and have even had to return significant amounts of funds if they were disallowed during audits. Many LEAs have also received unclear and inconsistent guidance from the state around Medi-Cal billing, leading many to opt out of the program.
It’s easy to see why LEAs are reticent to take advantage of Medi-Cal billing options when data from the Department of Health Care Services (DHCS) showed that 75% of LEA provider claims audited between 2007 and 2015 required some level of repayment to the state.
A recent survey also noted that auditors in other states take on a more supportive role, while California’s auditors have been more compliance-focused and punitive. Because of this, many LEAs have stopped participating in the LEA BOP to avoid dealing with burdensome audit requirements, unrealistic timelines, and excessive documentation demands.
According to a press release from AB 483’s author, Assemblymember Al Muratsuchi,
AB 483 Aims to Reform Medi-Cal Billing in California Schools
AB 483 expands access to school-based mental health and health services by making it easier for schools to participate in Medi-Cal billing through the LEA BOP, thereby increasing funding to support students in California schools. According to the AB 483 Fact Sheet, the auditing process will be reformed by DHCS, changing the way Medi-Cal claims from LEA BOP are handled. The goal of AB 483 will be to ensure:
- Schools are reimbursed for all eligible services not precluded by federal law
- All audits are completed, and the LEA is notified of the findings within 12 months of claims being made
- A final settlement of audits is performed, including completion of appeals, within 3 years
- Technical help is provided to LEAs, and they will be assisted with corrective action plans if more than 25% of claims must be repaid
- Expedited appeals of audits requiring repayment of more than 50% of an LEA’s total claims
- Key stakeholders are involved in the formulation of any state plan amendments needed to implement these provisions
- Annual reports on the number of LEA BOP audits completed, the amount of funds disallowed, and any technical aid provided to LEAs
Hope for the Future of Medi-Cal Billing & Funding for School-Based Mental Health Services
Governor Newsom’s signing of AB 483 was welcome news for many school districts across California. While many details have yet to be released, there is significant hope among those in education that California schools may soon have better access to Medicaid funds through Medi-Cal billing.
Assemblymember Muratsuchi’s words are surely music to the ears of anyone overseeing the tight budgets of school-based mental health services departments. Additionally, the average school psychologist, school counselor, or school social worker scraping by with an overburdened caseload may be heartened to hear that both the Los Angeles Unified School District(LAUSD) and the California Association of School Psychologists (CASP) were co-sponsors of AB 483. The LAUSD Superintendent recently had this to say about AB 483:
LAUSD and CASP are very aware of the need for more funding of school-based mental health services and look forward to AB 483 helping more students and families access services at local school sites. Hear what the President of CASP has to say about AB 483:
AxiomEHR: The Next Generation of School Software Support
In recent years, school districts have faced unprecedented challenges in meeting their students’ social, emotional, and behavioral needs.
To complicate matters, in 2022, California began the CalAIM Initiative, a multi-year process to transform Medi-Cal into a more coordinated, person-centered, and equitable health system. By 2027, Medi-Cal will become CalAIM, and in the process, a new system of billing requirements is being put into practice.
That’s where AxiomEHR comes in.
AxiomEHR is the next generation of EHR technology for school-based mental health services, built on the real-world insights of Exym.
For years, Exym has helped schools simplify case management and improve student support. Now, AxiomEHR takes that expertise even further, offering a more intuitive, powerful, and flexible solution designed specifically for the evolving needs of California school-based mental health programs.
With enhanced features like CYBHI and LEA-BOP billing support, customizable automations, and a modern user experience, AxiomEHR is redefining what school mental health provides can expect from their technology.
We Partner with California Schools to Simplify Compliance
When it comes to safeguarding student data and confidential documentation, AxiomEHR delivers peace of mind. Built with security and compliance at its core, our software can help schools confidently protect student information while streamlining complex billing processes.
Exym has supported schools for years, helping them manage student mental health services efficiently. Now, with Axiom, we’re delivering an even more powerful, purpose-built solution for school-based teams.
Discover how our technology has supported real districts delivering behavioral health services across California. Upland USD had this to say:
At Axiom, we understand how overwhelming it can be to learn new software and figure out billing claims, and we meet you right where you are. Our team already works with California school districts to help with:
- Daily case management
- Case notes in alignment with HIPAA
- Customizable access permissions
- Electronic signature gathering
- Data analytics and reporting
- Intern supervision
- Private insurance and Medi-Cal billing claims
Start building success for this school year and prepare for AB 483’s more straightforward access to CalAIM billing opportunities today! Take the first step by partnering with Axiom, a software provider familiar with California billing requirements and a team that local schools trust.
Click on the button below to schedule a demo with an expert who can answer your questions about using AxiomEHR for schools!
Brooke White
Want to Learn More?
Get our AB 483 Whitepaper to learn how California schools can tap into Medi-Cal funding to sustain mental health services.
