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Medicaid Reimbursement for IEP Services. IN Medicaid-covered IEP Services.

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Presentation on theme: "Medicaid Reimbursement for IEP Services. IN Medicaid-covered IEP Services."— Presentation transcript:

1 Medicaid Reimbursement for IEP Services

2 IN Medicaid-covered IEP Services

3 IEP-required R.N. services and Special Ed Transportation Just added:

4 What documentation is required? Documentation that a direct medical service was provided to an eligible Special Education student e.g., paper or electronic Service Log; Student Record Medical Necessity Documentation e.g., physician order; assessments; treatment plan/IHP General School Corporation Records e.g., financial; student & staff attendance; licensure Details online in the Medicaid Billing Tool Kit

5 Watch for Tool Kit Updates

6 There must be an order or referral for therapy and nursing services that are billed to Medicaid. The School Psychologist practice act, IC 20-28-1-11, defines “School Psychology” to include referring a student to: “(A) a speech-language pathologist or an audiologist licensed under IC 25-35.6 for services for speech, hearing, and language disorders; or (B) an occupational therapist licensed under IC 25-23.5 for occupational therapy services” Required Referral for Medicaid- reimbursed IEP Services

7 How does reimbursement work? Every Medicaid check = state + federal funds –At present: each Medicaid payment includes 75% federal & 25% state dollars –State funds “draw down” additional federal $ –Medicaid-participating school corporations recover a portion of their costs for providing Medicaid-covered health-related services to students with an Individualized Education Program (IEP)

8 Medicaid reimbursement example

9 How Many School Corps Bill? In Fiscal Year 2009: 71 In Fiscal Year 2010: 110

10 http://www.doe.in.gov/exceptional/speced/docs/SchoolCorpMedicaidReport.pdf Which Corporations Participate?

11 What resources are available? The Medicaid Billing Tool Kit & Guide Presentations, bulletins, reports Articles, Q&A, Newsletters Sample Forms Parent Information Brochure VISIT: http://www.doe.in.gov/exceptional/speced/medicaid.html

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15 IDOE’s Medicaid Web Page

16 National Resources on School- based Medicaid Services http://medicaidforeducation.org/ http://www.theleanet.com/

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