Medicaid Reimbursement
There are two ways in which Davis School District receives money from Medicaid. Medicaid Time Study and Medicaid Reimbursement (Service Tracking.) If you are looking for information on Medicaid Time Study, please click on Medicaid Time Study on the left menu.
Medicaid Basics
Welcome to Medicaid Reimbursement and Tracking!
Medicaid allows school districts to seek reimbursement for services performed that are Medicaid eligible. For the district to seek reimbursement, the following criteria must be met
- The student must have a current IEP.
- The school district must obtain parent permission to seek reimbursement.
- The student must have eligible related and, in some cases, special educational services on the IEP.
- The services must be delivered or supervised by qualified personnel.
- The school district must have documentation proving the services were delivered.
Current IEP
Districts cannot seek reimbursement for services provided during any time period for which the student does not have a current IEP. If the district receives reimbursement for any services provided with out a current IEP, the district will need to pay back any received funds. School teams need to make sure all timelines are met concerning eligibility and IEPs.
When using the Davis School District Service Tracking systems, personnel will not have access to a student whose eligibility or IEP has lapsed.
Parent Permission
Parent permission to seek Medicaid reimbursement is gained either by a paper copy or electronically through MyDSD. Paper copies are used in preschool or if the parents of a school age student does not use MyDSD. After the document is signed indicating the parents choice it is sent to the district special education office. If you are the case manager of a school age student, you may receive an email asking for help by either notifying the parents that there are documents to sign when they log in, or by sending a paper copy home.
Eligible Related Services on the IEP
The main service types that districts can be reimbursed for are: Evaluation and Assessment, Motor Skills Development, Communication Skills Development, Nursing services, Personal Care Services, Behavior Health Services, and Vision and Hearing Adaptation Services. Do not use these service type as the service title on the IEP. The majority of these services will be a related service, there are times when a special education service is Medicaid eligible. This occurs when the student only has one type of services on the IEP such as a student who only receives speech services, vision services, hearing services, or when there are only Behavioral Health services addressed on the IEP.
For more information on Medicaid Eligible services please see the Teacher or Related Server tab.
Services Delivered or Supervised by Qualified Personnel
In order to be reimbursed for Medicaid eligible services the service must be delivered in person or by Telemedicine. These services must be delivered or supervised by professionals who have the right credential for that service type.
For more information on who can supervise each service please see the Teacher or Related Server tab.
Documentation
Any district that receives money from Medicaid is expected to document these services and maintain the documentation for 5 years. Medicaid audits the districts for proof of services. If the districts documentation does not meet Medicaid criteria the money must be returned. If frequent errors are found Medicaid has the right to audit every student. The documentation needs to reflect: the type of service rendered, the amount of time rendering the service, the provider and supervisor, the signature of provider and supervisor (can be digital), clinical documentation or the activities performed and how the service was rendered.
Davis School District has developed a Service Tracking Tool through Encore. For more information on how to use this tool please see the Teacher or Related Server tab.
Teachers
IEP
In order to be reimbursed for Medicaid eligible services delivered to a student, the services must be accurately reflected on the IEP. This is the only time a teacher puts service time as a related service.
- Teachers should verify that each service on the IEP is still valid
- Does the student still need this service?
- Does the service still qualify as Medicaid eligible?
- Does the service title match the pull-down menu on MyIdea exactly?
- Is the service time still accurate?
- Is the service provider still accurate?
- MyIdea pull down menu
- Medicaid Eligible Services for Teachers
- Help Sheet: Student w/Medicaid Billable Services is not Showing up in Service Tracking - What to Check (.pdf)
- If the students only area of need is Behavior services
- Teacher enters service time under special education using pull down menu and selecting "Behavioral Skills"
- School psychologist enters any additional time as a Related Service.
Service Tracking
Medicaid Documentation
Medicaid has strict rules on documentation to verify that a service which was reimbursed for was prescribed by an IEP is delivered by qualified personnel. Davis School District has created a digital tracking tool that meets all the requirements put forth by the department governing Medicaid.
How the Encore Service Tracking System Works
The Encore Service Tracking System works in conjunction with DSD's MyIDEA compliance tool. It is a secure system that is password protected. It searches through the MyIDEA data base for students that meet Medicaid requirements (see the Medicaid Basics tab for requirements) and loads the student information into the system. Teachers and therapists can then select the student, Medicaid eligible service, the type of log required, and log the services delivered. They system also monitors for compliance by searching for Medicaid eligible services that have not been logged, requiring log specific information before signing, and verifying that each log was signed by the appropriate credentialed supervisor.
On the 26th of every month the tracking system sends emails concerning missing logs to the case manager and service provider, if the service provider has not been updated or left blank these emails will go to the wrong personnel. In order to verify that the Service Providers have been updated, generate a Service Provider Report. The Service Tracking System also has a monitoring tool that teachers and therapists can access at any time to see a history of emails that have been sent, logs that require signatures, and the time since each service has been tracked per student.
Help Sheet: Student w/Medicaid Billable Services is not Showing up in Service Tracking - What to Check (.pdf)
How to Update Contacts
How to Update Service Providers
How to Generate a Service Provider Report
Technical Guide for Using Service Tracking System
Video Demonstrating Service tracking System
Examples of Clinical Notes
Video Demonstrating Service Tracking Monitor (link)
Who can use the Encore tracking system?
All Special Education staff (Aides, Teachers, Therapists) can access and enter information into the tracking system. When entering information, the system automatically records the staff member entering the information. If multiple staff worked with the student on the same service, the notes should not only include the activities or clinical notes, but who provided the services. At the end of the month the logs are then signed by those who either delivered the service or supervised the service delivery. If a teacher or therapist is both the provider and supervisor, they can click on both areas and sign once.
FAQ
Who should I contact about Medicaid questions?
Related Servers- Dawn Sheen
Preschool Teachers - Chelley Fenton
Resource K-12 - Keri Vernier
Special Programs - Alice Richins
Vista Campus - James Gordon
Time Study - Cozette Freckleton
Technical Issues - Tom Johnson
What about Medicaid and Remote Instruction?
Medicaid Eligible services can be delivered at home through Telehealth. You should consider Telehealth time as DSD SPED Learning Plans are being developed. Telehealth services fall under Telemedicine in the Medicaid Provider Manual.
Telemedicine is two-way, real-time interactive communication between the member and the physician or authorized provider at a distant site. This electronic communication uses interactive telecommunications equipment that includes, at a minimum, audio and video equipment that complies with HIPAA and UHIN privacy and security standards for telehealth.
In Davis School District we ask that professionals use Teams (Skype for business) where possible. Zoom should only be used if there is a specific function needed to deliver the service that is not available in Teams.
When entering the information in the Service Tracking Log, include the method of delivery in the notes.
What do I do about Behavior Intervention Plan Implementation if it is no longer eligible for reimbursement?
Medicaid has determined that they will no longer pay for services using the titles such as Behavior Intervention Plan, because it doesn't explain the exact Medicaid service. If you have a student with Behavior Intervention Plan Implementation, it can be changed as the IEP comes do, or as part of an addendum.
Teams can consider using the Behavior Skills under related services. Service time should be calculated in the same way all other Special Education Services are calculated. Including evaluating the time spent actively engaged in teaching the associated goals. Time spent monitoring should not be counted as service time.
Why is my Medicaid Eligible service not in the tracking system?
With the changes in Medicaid this year, there are now more services under Special Education Services that qualify for Medicaid. There are also several services under Related Services that do not qualify for Medicaid. In order to make the automatic system work with these changes, service titles must match the pull-down menu exactly. If the student has Medicaid Eligible services that are not entered exactly the team will need to addend the IEP and use the pull-down menu to enter the services. This is considered a minor change to the IEP.
What do I need to do about my logging errors from last year (SY2020)?
There were close to 20,000 recorded errors in the 2019-20 school year. The majority of these were caused by programming issues. Over the course of the 2020-21 school year, you will be notified of what errors you need to correct. One of the summer updates is to have logs accessible for 12 calendar months. Your Medicaid representative will contact you.
Related Servers
Related Servers
IEP
In order to be reimbursed for Medicaid eligible services delivered to a student, the services must be accurately reflected on the IEP.
- Therapists should verify that their service on the IEP is still valid.
- Does the student still need this service?
- Does the service title match the pull-down menu on MyIdea exactly?
- Is the service time still accurate?
- Is the service provider still accurate?
- MyIdea pull down menu.
- If the students only area of need is Behavior services
- The teacher enters service time under special education using pull down menu and selecting "Behavioral Services." The teacher signs as provider and supervisor on their log.
- School psychologist enters any additional time as a Related Service and signs as provider and supervisor on their log.
- If the students only area of need is hearing or vision
- The hearing or vision teacher enters time under Special education.
- If a special education teacher is providing any teacher directed hearing or vision services, their time is entered as a related service. The Hearing or Vision teacher would sign as supervisor.
- If the student's only area of need is speech.
- The speech therapist enters time under Special Education.
- If a special education teacher is providing any teacher directed speech services, their time is entered as a related service. The speech therapist signs as the supervisor.
Service Tracking
Medicaid Documentation
Medicaid has strict rules on documentation to verify that a service which was reimbursed for was prescribed by an IEP is delivered by qualified personnel. Davis School District has created a digital tracking tool that meets all the requirements put forth by the department governing Medicaid.
How the Encore Service Tracking System Works
The Encore Service Tracking System works in conjunction with DSD's MyIDEA compliance tool. It is a secure system that is password protected. It searches through the MyIDEA data base for students that meet Medicaid requirements (see the Medicaid Basics tab for requirements) and loads the student information into the system. Teachers and therapists can then select the student, Medicaid eligible service, the type of log required, and log the services delivered. They system also monitors for compliance by searching for Medicaid eligible services that have not been logged, requiring log specific information before signing, and verifying that each log was signed by the appropriate credentialed supervisor.
Every month the tracking system sends emails concerning missing logs to the case manager and service provider, if the service provider has not been updated or left blank these emails will go to the wrong personnel. The Service Tracking System also has a monitoring tool that teachers and therapists can access at any time to see a history of emails that have been sent, logs that require signatures, and the time since each service has been tracked per student.
How to Update Contacts
How to Update Service Providers
How to Generate a Service Provider Report
Technical Guide for Using Service Tracking System
Video Demonstrating Service tracking System
Examples of Clinical Notes
Video Demonstrating Service Tracking Monitor (link)
Who can use the Encore tracking system?
All Special Education staff (Aides, Teachers, Therapists) can access and enter information into the tracking system. When entering information, the system automatically records the staff member entering the information. If multiple staff worked with the student on the same service, The notes should not only include the activities or clinical notes, but who provided the services. At the end of the month the logs are then signed by those who either delivered the service or supervised the service delivery. Therapist is both the provider and supervisor; they can click on both areas and sign once.
FAQ
Who should I contact about Medicaid questions?
Related Servers- Dawn Sheen
Preschool Teachers - Chelley Fenton
Resource K-12 - Keri Vernier
Special Programs - Alice Richins
Vista Campus - James Gordon
Time Study - Cozette Freckleton
Technical Issues - Tom Johnson
What about Medicaid and Remote Instruction?
Medicaid Eligible services can be delivered at home through Telehealth. You should consider Telehealth time as DSD SPED Learning Plans are being developed. Telehealth services fall under Telemedicine in the Medicaid Provider Manual.
Telemedicine is two-way, real-time interactive communication between the member and the physician or authorized provider at a distant site. This electronic communication uses interactive telecommunications equipment that includes, at a minimum, audio and video equipment that complies with HIPAA and UHIN privacy and security standards for telehealth.
In Davis School District we ask that professionals use Teams (Skype for business) where possible. Zoom should only be used if there is a specific function needed to deliver the service that is not available in Teams.
When entering the information in the Service Tracking Log, include the method of delivery in the notes.
What do I do about Behavior Intervention Plan Implementation if it is no longer eligible for reimbursement?
Medicaid has determined that they will no longer pay for services using the titles such as Behavior Intervention Plan, because it doesn't explain the exact Medicaid service. If you have a student with Behavior Intervention Plan Implementation, it can be changed as the IEP comes do, or as part of an addendum.
Teams can consider using the Behavior Skills under related services. Service time should be calculated in the same way all other Special Education Services are calculated. Including evaluating the time spent actively engaged in teaching the associated goals. Time spent monitoring should not be counted as service time.
Why is my Medicaid Eligible service not in the tracking system?
With the changes in Medicaid this year, there are now more services under Special Education Services that qualify for Medicaid. There are also several services under Related Services that do not qualify for Medicaid. In order to make the automatic system work with these changes, service titles must match the pull-down menu exactly. If the student has Medicaid Eligible services that are not entered exactly the team will need to addend the IEP and use the pull-down menu to enter the services. This is considered a minor change to the IEP.
What do I need to do about my logging errors from last year (SY2020)?
There were close to 20,000 recorded errors in the 2019-20 school year. The majority of these were caused by programming issues. Over the course of the 2020-21 school year, you will be notified of what errors you need to correct. One of the summer updates is to have logs accessible for 12 calendar months. Your Medicaid representative will contact you.
List of changes in 21-22 school year
We are still waiting for the 21-22 Medicaid Manual! Updates will be emailed to each department for training when available.
The 20-21 school year changes will be implemented in phases.
August
All special education students with Medicaid eligible services are eligible for reimbursement. There is no longer a minimum service time. This will mean that hearing only, vision only and behavior only student's services will now need to be tracked in the Medicaid tracking tool.
On Going
Medicaid will no longer reimburse school districts for certain medical services performed by teachers. This means that teachers will no longer be required to complete Medicaid tracking for these services, they will however, need to continue to track procedures for nursing. These services can be moved to special education time or addressed as accommodations. These services include:
- Personal/Health Care Catheterization
- Personal/Health Care Colostomy Care
- Personal/Health Care Medication Administration
- Personal/Health Care Positioning
- Personal/Health Care Tube Feeding
Medicaid will no longer reimburse school districts for service time categories that do not describe the type of Medicaid eligible services actually performed. These services in the MyIDEA pull down menu will no longer be tracked. Updated service titles are being developed and training will be provided as soon as possible.
- Behavior Intervention Plan Implementation
Medicaid will now allow the district to seek reimbursement for evaluation and assessments for the purpose of identifying and documenting a health related (Medicaid Eligible) service. The evaluation and assessment will need to be noted on the IEP.
- This will allow us to be reimbursed for any standardized testing related to communication, motor skills, hearing, vision and behavioral skills.
- We have not finalized how this will be represented on the IEP or developed a billing system.
There will be ongoing changes in the year 20-21. Medicaid has promised clarifying documents "soon."
Links
Problems with Service Tracking, Submit a Support Ticket Here
How to Update Contacts
How to Update Service Providers
How to Generate a Service Provider Report
Technical Guide for Using Service Tracking System
Video Demonstrating Service tracking System
Examples of Clinical Notes
MyIdea pull down menu
Medicaid Eligible Services for Teachers
School Based Services Provider Manual
Medicaid for Resource Teachers Part 1
Medicaid for Resource Teachers Part 2
Medicaid for Resource Teachers Part 3
Corrections: