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2008 NAME Conference
September 24-26th, 2008
Hyatt Regency Philadelphia at Penn’s Landing, PA
Online Conference Registration Now Available.
Visit the 2008 conference page for more information
Welcome to the National Alliance for Medicaid in Education Home Page!
The National Alliance for Medicaid in Education (NAME) represents the nation's Medicaid and Education agency staff, along with local education agency administrators, with programmatic responsibility for administering Medicaid's Administrative Claiming and Direct Billing of Health Related Service programs in schools. The primary purposes of NAME are to provide an information network among the states on issues pertinent to the Medicaid programs in schools and to act as a focal point of communication between the states.
News
Latest E-tag
July 1, 2008
Read about the moratoria passing (since E-tag was printed the president signed the bill), 2008 Conference Highlights, Consider the Academy, NPI-IRS Data Mismatch and more.
July 2008 E-tagBill Passes
June 27, 2008
In a 92 to 6 vote, the U. S. Senate approved the War Supplemental Appropriations bill that included moratoria until April 2009 on six Medicaid regulations. The Senate approved the language that the House passed last Friday. The President is expected to sign the bill into law, probably in the coming week. The six regulations that will be on moratoria are: Targeted Case Management, Rehabilitation Option, School Based Services, Public Provider Cost Limit, Graduate Medical Education, and Provider Tax. Left out of the package was the seventh regulation dealing with reimbursement for Outpatient Services. That regulation is not expected to be finalized by CMS until November; additionally, it is not clear if it can be finalized given that the GME and Public Provider regulations are covered by the moratoria as there are financial linkages.
State Medicaid Directors send letter to Speaker Pelosi
June 10, 2008
State Medicaid Directors thank Speaker Pelosi for past support and ask for her continued support for the Medicaid Regulations Moratoria.
Controversial Medicaid Rules
May 28, 2008
Check out End Runs on Medicaid an editorial in the May 28, 2008 edition of the New York Times about the contested CMS Medicaid rules and the Congressional efforts to invoke a moratorium read.LEAnet is hosting a Live National Webcast on Medicaid in the Schools! May 21, 2008
May 19, 2008
LEAnet will host a live webcast on May 21st from 1:00 – 3:00 EST on the current status of Medicaid in Schools. For details on the event and how to participate please visit:
E-tag First Edition
May 1, 2008
NAME has developed a new one page newsletter that highlights current issues that impact Medicaid in Education. Look for it at the beginning of every month.
CBO Cost Estimate on HR 5613
April 22, 2008
Congressional budget office cost estimate on HR 5613 Protecting the Medicaid Safety Net Act of 2008.
Medicaid Regulations Moratoria
April 3, 2008
Health Subcommittee hearing on H.R.5613, the "Protecting the Medicaid Safety Net Act of 2008," to extend certain moratoria and impose additional moratoria on certain Medicaid regulations through April 1, 2009. Witness ListCoalition sends letter to Congressmen Dingell and Murphy
April 2, 2008
Attached is a letter from the Coalition to Preserve the Medicaid Safety Net, consisting of 820 organizations representing public health, disability, education, hospital, organized labor, health care providers and others giving support to Congressman John D. Dingell and Tim Murphy’s bill “Protecting the Safety Net Act of 2008”. The bill calls for a one year moratorium on CMS Medicaid Cuts.NGA Supports Moratorium
April 2, 2008
The National Governors Association sent a letter of support to Congressmen Dingell and Murphy in support of the Moratorium Bill for the recent CMS cuts to Medicaid.New Report Indicates Medicaid Rules Would Hurt Special Needs Children
March 17, 2008
A new report released by First Focus indicates that the Administration’s new rules for Medicaid and the State Children’s Health Insurance Program, if imposed, will have a disproportionate impact on children with special health care needs.
Commissioned by First Focus and authored by Sara Rosenbaum, JD, of The George Washington University Medical Center’s School of Public Health and Health Services, the report has analyzed each of the regulations proposed by the Centers for Medicare and Medicaid Services (CMS), and determined that vulnerable children with special health care needs will be most severely impacted by these actions.
- Click here to download the full report.
- Click here to read the First Focus summary of the report
- Click here to read First Focus's Press Release
- Click here to read a summary of CMS regulatory actions impacting children with special health care needs
Dingell &Murphy introduce bill to place moratorium on 7 CMS regulations
March 14, 2008
A bill was introduced by Congressman John Dingell and Tim Murphy that would extend or place a temporary moratorium through April 1, 2009 on 7 CMS regulations.
Congressional Assessment of Medicaid Cuts
March 3, 2008
The UNITED STATES HOUSE OF REPRESENTATIVES COMMITTEE ON OVERSIGHT AND GOVERNMENT REFORM MAJORITY STAFF assessment of Medicaid Cuts may be found in the MARCH 2008 document THE ADMINISTRATION’S MEDICAID REGULATIONS: STATE-BY-STATE IMPACTS.
National Governors Association requests for delay
February 26, 2008
The National Govenors Association requested Congress in a February 26th letter to delay the implementation of the CMS regulation changes.
Confused About the Status of CMS Rules
February 14, 2008
The LEANet web site has a summary of the recent CMS rules impacting Medicaid in Education and their status.
Congressional Research Service report Medicaid and the State Children’s Health Insurance Program
February 13, 2008
The Congressional Research Service report Medicaid and the State Children’s Health Insurance Program (SCHIP): FY2009 Budget Issues issued February 6, 2008 and written by Cliff Binder, Evelyne P. Baumrucker, April Grady, Jean Hearne, Elicia J. Herz, and Julie Stone Domestic Social Policy Division addresses school based issues on targeted case management match rate moving to 50% and CMS intention to issue proposed regulations to codify their "Free Care Rule".
OIG to Look at Bundled Rates for School Based Providers according to Audit Plan
February 8, 2008
Use of Bundled Rates for Payment to Medicaid School-Based Providers
We will review the use of bundled rates for Medicaid school-based services compared to an FFS reimbursement methodology. School-based health services are reimbursable under the Medicaid program for students with special needs pursuant to individualized education plans. Under section 1902(a)(30)(A) of the Social Security Act, States are required to have methods and procedures to ensure that payments are consistent with efficiency, economy, and quality of care. A 2000 GAO review concluded that the bundled payment methods used in seven States failed in some cases to consider variations in service needs among children. We will determine whether the bundled rate systems currently used by States result in payments that are different from the amounts that would be paid under an FFS reimbursement methodology. (OEI; 05-07-00570; expected issue date: FY 2008; work in progress)
If passed Senate and House Bills would place Moratorium on 2237
February 1, 2008
If passed, there would be a moratorium on the implementation of CMS rule 2237 until April, 1 2009.
NY Gov Includes Moratorium on CMS rules as one of 12 Top Priorities
February 1, 2008
As part of his top 12 federal priorities Eliot Spitzer requested NYS Congressman to work on legislation to secure a moratorium on CMS rules that impact health care including school based health, rehabilitation and targeted case management services.
Letter to Congress
January 14, 2008
Governors from several states ask for Congressional intervention to support the extension of moratoriums on CMS rules. Letter
CRS Report To Congress - Medicaid and Schools
January 8, 2008
Medicaid and Schools dated December 20, 2007 is an update to The Link Between Medicaid and the Individuals with Disabilities Education Act(IDEA): Recent History and Current Issues also writen by Alica Hertz and issued March 9, 2006.OSEP Responds to Question from NAME - Is an LEA required to go after Medicaid for IDEA Services?
January 7, 2008
OSEP responded to question from NAME - Does 34 CFR 300.154(a)(1)34 CFR §300.154(a)(1) “…The financial responsibility of each noneducational public agency described in paragraph (b) of this section, including the State Medicaid agency and other public insurers of children with disabilities must precede the financial responsibility of the LEA (or the State agency responsible for developing the child’s IEP)” require an LEA to claim for Medicaid reimbursement? Link to OSEP response.
CMS Issued Final Rule on School Based MAC and Transportation – But Wait -
December 28, 2007
CMS issued rule 2287 eliminating Medicaid Administrative Claiming and severely limiting Medicaid claiming for school based special transportation claims. However recently passed legislation placed a moratorium on implementing the rule until June 2008.
“In the final regulation, CMS maintained the proposed prohibition on federal Medicaid reimbursement for administrative activities performed by school employees or contractors, and for transportation of students from home to school. However, under recently passed legislation, there will be a six-month delay in implementing these changes so school budgets in the 2007-2008 school year will not be affected.”
S-CHIP bill signed 12-29-07 by President Bush
To see comments to the draft rule choose the Medicaid Information drop down and select Proposed CMS Rules and Comments.NEW STATE DATA on Children with Special Health Care Needs
December 26, 2007
www.childhealthdata.org The Child and Adolescent Health Measurement Initiative (CAHMI) is pleased to announce "point and click" online access to national- and state-level findings from the JUST RELEASED 2005/06 National Survey of Children with Special Health Care Needs (NS-CSHCN). Visit the CAHMI Data Resource Center (DRC) website to quickly and interactively compare the new 2005/06 NS-CSHCN data for over 100 child health indicators. Users can also select and download findings for various population subgroups, including household income level, race/ethnicity, and insurance coverage.
Online access to the NEWLY RELEASED 2005/06 National Survey of Children with Special Health Care Needs
The NS-CSHCN is a national survey sponsored and designed by the federal Maternal and Child Health Bureau. It is administered by the National Center for Health Statistics. The survey was conducted for the first time in 2000/01, and repeated again in 2005/06.
The survey provides national and state-specific prevalence estimates for children with special health care needs, in combination with other information about their health, health care needs and the quality of care CSHCN receive. Data inform policymakers, advocates, and researchers dedicated to advancing the health of children who require health services for any type of ongoing health condition.
Waxman Hearings
November 2, 2007
Congressman Henry A. Waxman held hearings at the beginning November on CMS regulations impacting Medicaid. To view the testimony or the video of the hearings go to the link below.
http://oversight.house.gov/story.asp?ID=1578
OIG Issues Report on Utah School Based Program
November 1, 2007
Medicaid School-Based Services in Utah - Review of Payment Rates
(A-07-06-04069) http://www.oig.hhs.gov/oas/reports/region7/70604069.pdf
The State agencys claims for Medicaid reimbursement for school-based
services generally were not in accordance with Federal requirements or
the State plan. We were unable to determine what portion of $36.8
million of the $37.9 million claimed was allowable as final payments.
The State agency did not perform a cost settlement reconciling interim
payments to actual costs to determine final payments, as required by the
State plan, because it considered payments made to school districts to
be final payments. The State agencys claims for the remaining $1.1
million, which were for nursing services that were paid based on the
Medicaid fee-for-service schedule, were allowable.
We recommended that the State agency (1) work with the Centers for
Medicare and Medicaid Services to determine what portion of the $36.8
million claimed based on interim payments is allowable and (2) perform
cost settlements to ensure that future final payments for school-based
services are based on actual costs. The State agency concurred with the recommendations.
Waxman Hearings
November 1, 2007
The Congressional Committee on Oversight and Government Reform, Chaired by Henry Waxman, held a hearing 11/1/07. The Committee is very concerned about the recent plethora of proposed rules coming out of the Centers for Medicare and Medicaid Services (CMS). The written testimonies can be found at http://oversight.house.gov/story.asp?ID=1578 .
Comments to Proposed CMS Rules
October 12, 2007
Comments to proposed CMS Rules are being posted in the drop down
Medicaid Information under the Comments on Proposed CMS Rules or
simply click here.
Medicaid Overview
March 25, 2007
The Kaiser Commission recently issued a 2 page overview of the Medicaid Program. Medicaid Overview
OSEP Response to NAME on Parental Consent
March 1, 2007
OSEP responded to an October 12, 2006 letter from NAME requesting clarrification on the issue of parental consent.
CMS Proposed Rule on Governmentally Operated Providers.
February 21, 2007
The National Association State Medicaid Directors defines terms and outlines the implications of the CMS Proposed Rule on Governmentally Operated Providers
The National Association State Medicaid Directors in their January Medicaid Monthly Bulletin described the CMS’s Notice of Proposed Rule on cost limits for governmentally operated providers as seeking “to clarify that entities involved in the financing of the non-federal share of Medicaid payments must be a unit of government; clarify the documentation required to support a certified public expenditure; limit reimbursement for health care providers that are operated by units of government to an amount that does not exceed the provider’s cost; require providers to receive and retain the full amount of total computable payments for services furnished under the approved state plan; and make conforming changes to provisions governing the State Child Health Insurance Program (SCHIP).”
NASMD said that the CMS proposed rule on cost limits for governmentally operated providers may impact many of the nation’s public schools that claim Medicaid funds for direct services. The proposed rule includes terms such as NPRM, CPE, IGT, units of government, and cost limits. (Many of our members heard these terms for the first time during the CMS presentation at the NAME 2006 conference – explanations of these terms and more are included in the article).
To find out more about the proposed rule and its potential impact visit their web site at www.NASMD.org and under News and Updates select the link to :
NPRM on Cost Limits for Governmentally Operated Providers.
Protecting Children's Health in Schools Act of 2007
February 20, 2007
The "Protecting Children's Health in Schools Act of 2007" has now been introduced in both houses thanks to Senator Ted Kennedy and Representative John Dingell.
Commerce Clearing House - Proposed Limits on Public Providers
February 11, 2007
Commerce Clearing House reports the impact of the CMS proposed rule limiting Medicaid reimubursement to governmental providers may impact school districts.
Kaiser Commission Key Facts on IGTs
February 11, 2007
Intergovernmental transfers used by some Statesfor the Medicaid match, explained inThe Kaiser Commission 2005 Key Facts document, led to the new rule proposed by CMS.
CMS Proposed Rule
February 1, 2007
Proposed CMS Rule - Cost Limit for Providers Operated by Units of Government and Provisions To Ensure the Integrity of Federal-State Financial Partnership. Comments are due by March 19, 2007. This rule will impact many State Medicaid in Education Programs.
Parental Consent
January 23, 2007
Alexa Posny, Director of the Office of Special Education Programs at the United States Department of Education addresses the frequency of obtaining parental consent when a school district bills Medicaid or other public funds.
CMS ISSUES GUIDANCE ON THE DRA OF 2005 CHANGES TO THIRD PARTY LIABILITY
December 15, 2006
CMS issued State Medicaid Director Letter (SMDL) #06-026 which explains intent of the Deficit Reduction Act of 2005 was to “…strengthen State’s ability to identify and collect from liable third party payers.” They also issued 13 excellent question and answers concerning this part of the Act.
Commonwealth Fund Reports
December 11, 2006
Lawmakers and Lobbyists Urge Action in Congress to Prevent Medicaid Cuts
By Mary Agnes Carey, CQ HealthBeat Associate Editor
A brief article outlining the implications for all programs (including school-based services) and growing opposition to the imminent issuance of HHS regulations that would reduce Medicaid payments in excess of $12 billion over the next 5 years.
A Project Forum Report - School Based Medicaid for Children with Disabilities
October 25, 2006
The National Association of State Directors of Special Education issue a Project Forum Report titled School-based Medicaid for Children with Disabilities by Kim Moherek Sopko
Project Forum gives special acknowledgement NAME and NCRRC for sharing survey information with our staff. The interview questions for this document were prepared based on a review of the NAME/NCRRC survey.
This policy analysis provides a brief background of how the Medicaid program interfaces with the Individuals with Disabilities Education Act of 2004 (IDEA) and an analysis of how Medicaid resources are accessed and used in five states. Project Forum at the National Association of State Directors of Special Education (NASDSE) produced this document as part of its cooperative agreement with the U.S. Department of Education’s Office of Special Education Programs (OSEP).
NAME ASKS FOR CLARIFICATION ON PARENTAL CONSENT
October 13, 2006
NAME sends letter to OSEP that requests clarification of federal regulation
34 CFR § 300.154 (d)(2)(iv)(A) that requires local education agencies to
obtain parental consent to access to public benefits.
US Department of Education Announces New Web Site to Assist Users in Navigating the New IDEA
September 5, 2006
This site was created to provide a "one-stop shop" for resources related to IDEA and its implementing regulations, released on August 3, 2006. It is a "living" website and will change and grow as resources and information become available. When fully implemented, the site will provide searchable versions of IDEA and the regulationsCMS Releases Comprehensive Medicaid Integrity Plan
July 19, 2006
On Tuesday, July 18, 2006, the Centers for Medicare & Medicaid Services (CMS) released the initial Comprehensive Medicaid Integrity Plan. Under the provisions of the Deficit Reduction Act (DRA) of 2005, Congress provided resources to CMS to establish the Medicaid Integrity Program (MIP). MIP represents the first national strategy to detect and prevent Medicaid fraud and abuse in the programs history. Under the leadership of the Center for Medicaid & State Operations (CMSO), the agency will fulfill the mandates of this new program. The Comprehensive Medicaid Integrity Plan will guide CMSs efforts to fulfill this new obligation.
Press Release regarding this announcement.
Access to State Medicaid, Education, Special Education and Medicaid in Education Policies
July 11, 2006
2005 Special Education Medicaid Billing Survey
June 15, 2006
NOW AVAILABLE
