NAME 2009 Biennial Survey Trends and Data Results (US)

February 1, 2011

The National Alliance for Medicaid in Education (NAME) hosted a national conference call to review the results of the NAME 2009 Biennial Survey Trends and Data. The survey collects data to identify trends in school-based Medicaid direct service billing and administrative claiming. There were close to 100 participants in the conference call held on January 25, including representatives from school districts, state Medicaid and education agencies, Centers for Medicare and Medicaid Services, the American Association of School Administrators, the Office of Special Education Programs, the National Association of State Directors of Special Education, and the Council of Administrators of Special Education. The conference call was held to discuss the data collected on direct billing for IEP services and Medicaid Administrative claiming, how data was collected and who responded, service coverage and top issues for states when it comes to Medicaid billing.

To collect data, a survey was distributed via Survey Monkey to Medicaid and education contacts in each of the 50 states. Contacts from 28 of the 50 states responded to the survey. The data shows that the overall total federal reimbursement for both direct billing and administrative claiming has been on the decline since 2005, although the current decrease is not as steep as the past few years. Of the 22 states that contributed data on Medicaid coverage, all 22 reported covera ge for IEP required Occupational Therapy, Physical Therapy, and Speech-Language Pathology services. 20 of the 22 states also provide coverage for mental health services required by an IEP. Participants in the survey indicated that obtaining accurate service documentation and parental consent are the biggest obstacles for direct service billing. For administrative claiming, participation and the time survey methodology were listed as the biggest obstacles.

The complete analysis and report will be completed by February 21, 2011 and posted to the NAME website by February 28, 2011.

To access the PowerPoint presentation that was created for the conference call, visit: http://www.medicaidforeducation.org/filelibrary-name/webcommittee/Topical_Calls/Topical_Call_PDF/NAME_2009_Biennial_Survey_Trends_and_Data_1_19_2011_Rev.pdf. 

To access the NAME website where the report will be available, please visit: www.medicaidforeducation.org.