|TO:||School District Representatives and Other Interested Parties|
|FROM:||Carolyn Stanford Taylor, Assistant Superintendent|
Division for Learning Support: Equity and Advocacy
Department of Public Instruction
James Johnston, Chief Financial Officer
Wisconsin Medicaid and BadgerCare Plus
|RE:||School-based Services (SBS) and Medicaid Administrative Claiming (MAC) – Student Confidentiality and Parental Consent|
Under the Individuals with Disabilities Education Act (IDEA), schools deliver a broad range of educational and related services (e.g., educational, social and medical) to students with disabilities that address their diverse needs. Obtaining sufficient funding to cover increasing costs of services for students with disabilities is a critical responsibility for school districts. The Social Security Act specifies that states can receive federal Medicaid funding for certain services provided to children under the IDEA.
This memo provides a brief background of how the Medicaid program interfaces with the Individuals with Disabilities Education Improvement Act of 2004 (IDEA) and relevant state education law. In particular, this memo addresses the educational requirements of student confidentiality and parental consent to bill Medicaid within the Medicaid system of billing, data collection, and monitoring for Wisconsin’s School-based Services program and the Medicaid Administrative Claiming program. This memo applies to claims submitted on services provided Spring 2006 and forward.
|1.||How do IDEA and Medicaid work together?|
|2.||How are benefits calculated for the School-based Services program and the Medicaid Administrative Claiming (MAC) program?|
|3.||Do districts need parental consent to release to the Department of Health Services (DHS) the student rosters necessary for MAC and SBS benefits calculation?|
|4.||If a parent has requested that a school not disclose directory information1, may a district include that student for purposes of calculating benefits under MAC or SBS?|
|5.||If a parent has not yet provided consent to bill Medicaid (DPI Form M-52), may a district include that student for purposes of calculating benefits under MAC or SBS?|
|6.||How are claims submitted for reimbursement through MAC and SBS?|
|7.||Is parental consent required to submit claims under MAC and SBS?|
Questions and answers
For more information, please contact Richard Albertoni, Department of Health Services, at 608/266-9438 or Richard.firstname.lastname@example.org or Courtney Reed Jenkins, Department of Public Instruction, at 608/267-9183 or email@example.com.
1Schools must tell parents and eligible students about directory information and allow parents and eligible students a minimum of 14 days to request that the school not disclose directory information without their consent. Schools must notify parents and eligible students annually of their rights under FERPA and 118.125, Wis. Stats.
2The Department of Public Instruction provides sample forms and notices for use in the IEP team process to assist districts to comply with state (Chapter 115) and federal (IDEA) special education requirements. The forms are available online at http://sped.dpi.wi.gov/sped_form_int.