NAME regions

From Region V (IN, WI, MN, MI, OH)

Representative Mark Smith (OH)

Indiana: During May, Department of Education officials John Hill and Tracy Brunner conducted three daylong trainings throughout various regions of Indiana on Medicaid in education programs. John and Tracy worked in cooperation with representatives from the state's Medicaid agency claims contractor and the Education agency's IEP and MAC coordination areas. Additionally, CMS Region V's Lead Funding Specialist provided an overview of federal auditing at each session.

Wisconsin: Carlynn Higbie, a Wisconsin-based school therapy consultant with MJ Care, is collaborating with Medicaid in education officials both within and beyond the Region V area to begin discussing the topic of medical progress reporting and goal writing. While states vary in how they interpret these requirements, she hopes the discussion will help add perspective and clarify the benefits for both IDEA requirements as well as Medicaid's requirements for medical necessity of services delivered in schools.

Minnesota: The education and Medicaid agencies continue working together to seek possible solutions to two issues: third party liability and consent to share private information with Medicaid. While no final solution has been reached for either process, strides are being made. On the consent issue, the ability to indicate consent through the Medicaid application is under consideration. As to third party liability, the agencies are looking at ways to aggregate (at the health plan level) the denials of reimbursement for school-based services. These actions have potential to substantially reduce the administrative burden at the LEA level. Also, the state is in the midst of a program evaluation conducted by Fairbanks, LLC that includes a survey of parents, school staff, school administrators and state agency staff, and has thus far received good response rates.

Michigan: Michigan reports that the school districts submitted their second annual cost reports for direct services , and the analysis, cost settling and reconciliation continue to move along but a little slower this year. In the past six months, five major staff members at the Medicaid agency, whose work included the School Based Services Program, either retired or moved to new positions. This has resulted in some processing delays. However, the lines of communication remain open thanks to the ongoing collaboration between all parties-the education and Medicaid departments, as well as the Intermediate School Districts (ISDs).

Ohio: Ohio has entered into the final stage of its program implementation by beginning to process cost reports from school districts from its initial program year. The Ohio Medicaid School Program (MSP) requires all participating districts to submit a cost report that must be verified by an independent CPA in order to substantiate program costs and payments.

From a policy perspective, Ohio's education agency is working with the state Speech and Hearing Board to clarify how licensure statutes impact Medicaid reimbursement potential. Issues related to telepractice and its potential impact on service delivery, are undergoing clarification as well.