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Medicaid Reimbursement for IEP Services

Medicaid Reimbursement for IEP Services. IN Medicaid-covered IEP Services. Just added:. IEP-required R.N. services and Special Ed Transportation. What documentation is required?. Documentation that a direct medical service was provided to an eligible Special Education student

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Medicaid Reimbursement for IEP Services

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  1. Medicaid Reimbursement for IEP Services

  2. IN Medicaid-covered IEP Services

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

  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. Required Referral for Medicaid-reimbursed IEP Services 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”

  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 2010: 110 In Fiscal Year 2009: 71

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

  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

  12. IDOE’s Medicaid Web Page http://www.doe.in.gov/exceptional/speced/medicaid.html

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

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