Medicaid Parental Consent – A guide to maximizing the collection of Medicaid parental consent
June 21, 2017
Collecting Medicaid parental consent is one of the greatest challenges school districts face in claiming Medicaid reimbursement for health-related services provided to students with an Individualized Education Plan (IEP). When presented with parental consent forms, parents often have concerns about school districts accessing their public insurance benefits and school personnel are not always able to address those concerns or stress the importance of obtaining consent. As a result, school districts can miss out on a valuable source of funding, while still being required to provide services prescribed in students’ IEPs.
So how does a school district maximize the collection of Medicaid parental consent? Quite simply, make it standard to review and collect consent forms during every IEP meeting and ensure staff are prepared to answer the common questions listed below related to school-based Medicaid and parental consent. Finally, if you have an IEP service tracking and claiming system in place, use the data to help target your efforts at obtaining consent for students with the greatest number of billable services.
What is school-based Medicaid billing?
School based Medicaid billing is a federal program that reimburses school districts for the cost of providing health-related services that are prescribed in students’ IEPs. While reimbursable services vary from state to state, they can include, but are not limited to, speech therapy, occupational therapy, physical therapy, audiology, nursing services, personal care services, psychological services, and specialized transportation.
Why does the school district request parental consent from all parents and not just those enrolled in Medicaid?
Obtaining consent for all students allows the school district to maximize potential reimbursement because Medicaid eligibility can be fluid and students can become eligible for Medicaid at any point in time. Requesting consent from every parent/guardian during the IEP process also protects the privacy of each family by not basing the request on Medicaid eligibility status.
Does consent allow the school district to bill private insurance?
No. The consent is solely used to bill public insurance/Medicaid.
Will coverage for services provided outside the school district be impacted if the school district bills Medicaid?
No. If the school district bills Medicaid for IEP health-related services it provides, it has no effect on Medicaid coverage for services provided outside of the school district.
If a parent does not consent, does it impact the services their child is entitled to in school?
No. Regardless of whether a parent/guardian consents to bill Medicaid, the school district is still required to provide the services written in the student’s IEP as per the Individuals with Disabilities Education Act (IDEA).