Billing Medicaid for Health-Related Services in
Student’s Individualized Education Program (IEP) Annual Notification.

Why are school districts billing Medicaid?

The  Individuals  with  Disabilities  Education  Act  (IDEA)  allows  certain  services  provided   under  an  Individualized Education  Program  (IEP)  to  be  covered  by  Medicaid.  Medicaid   funds  help  pay  for  the  costs  of  providing  these services.

What can school districts bill Medicaid for?

School districts can only bill for health-related services that are outlined in the student’s IEP.  In general, services for which school districts may bill Medicaid are: hearing & vision services,  nursing services, personal care services, assistive technology services, occupational therapy  services, physical therapy services, speech & language therapy services, psychological services and  psychotherapy counseling.

Do school districts need parental consent to bill Medicaid?

Yes. Before billing Medicaid for the first time, the school district must ask for your permission  to bill your or your child’s  public  benefits  or  insurance  to  pay  for  your  child’s  related services  under  the  IDEA.  School  districts  are required  by  the  Family  Educational  Rights and  Privacy  Act  (FERPA)  to  obtain  parental  consent  before  sharing information about a  student. This includes sharing personally identifiable information about a student to Medicaid. To  receive funding from Medicaid to help pay for the cost of services, the school district must have parental consent to bill Medicaid.

Can parents withdraw their consent to bill Medicaid?

Yes. Parents have the right to withdraw their consent at any time.

If consent is not given by parents to bill Medicaid, will their children still receive IEP  services?

Yes. Districts are required to provide all IEP services, at no cost to parents, even if the district cannot bill Medicaid. A school district may not require parents to sign up for or enroll in public insurance programs in-order for their child to receive a free, appropriate education  under IDEA, Part B.

If school districts bill Medicaid, will Medicaid services that parents or guardians receive outside 
school be affected?

No. Medicaid services received outside school and the child’s IEP are authorized separately. The district may not use your child’s benefits under a public benefits or insurance program if that use would result in a decrease of any other insured benefit; result in the family paying for services that would otherwise be covered by a public benefits or insurance program and that are required for the child outside of time the child is in school; result in discontinuation of coverage; or result in the risk of loss of eligibility for home and community based waivers based on aggregate health-related expenditures.

Are school districts required to notify parents?

If so, how often must parents be notified? As the parent or guardian of a student who has or may 
have a disability, you  have  certain  rights  under  federal  and  state  law.  Your  child’s  school  district  must  provide  you  with  written notification of these rights regarding parental 
consent prior to accessing your public benefits or insurance for the first time and annually thereafter. This document serves as your written notification.

Where can parents get more information about this?

The US Department of Education Website: http://www2.ed.gov/policy/speced/reg/idea/part-b/part-b- parentalconsent