HBS Topics of the Week

We have just begun the seventh year of the Ohio Medicaid School Program (MSP). The Ohio Department of Medicaid (ODM) is still behind on doing Desk Reviews and issuing Final Settlement Payments, but they are making progress. We are currently finalizing an agreement with ODM that sets strict deadlines on both Cost Report Filing and Final Settlement Payments.

Below is the current status of the open MSP years:

MSP Reporting Periods:

July 1, 2011 – June 30, 2012     Year 3     ODM Desk Review

July 1, 2012 – June 30, 2013     Year 4     Final Due Date is 09/30/2015

July 1, 2013 – June 30, 2014     Year 5     Cost Report is due 12/31/15

July 1, 2014 – June 30, 2015     Year 6     Last School Year

July 1, 2015 – June 30, 2016     Year 7     Current School Year

2011/12 (Year 3) – ODM is just starting to issue Settlement Letters, so Final Settlements checks should start to be released sometime over the next few months.

2012/13 (Year 4) – Most all Cost Reports and AUP Audits have been filed and completed. The final due date after extensions is 09/30/2015. Hopefully Cost Settlement for this year will occur before the end of the 15/16 school year.

2013/14 (Year 5) – Cost Reports are being completed and sent to CPA firms for AUP Audit completion. The initial due date for this Cost Report is 12/31/2015.

2014/15 (Year 6) – Although the school year has ended, a Cost Report cannot be completed until the 365 day claim filing limit has ended. It is not too late for therapist to submit Service Documentation or parents to sign Parental Consent Forms so additional Interim Claims can be processed for this school year.

2015/16 (Year 7) – Districts should start seeing regular Interim Claiming payments each month based on therapist service documentation and Parental Consent forms received.

Our Medicaid topic several weeks ago stressed the importance of getting “Signed Parental Consent”, and explained how your Medicaid School Program reimbursement will decrease if a “PR-10 Form” is not obtained for all Medicaid students. A random audit of Parental Consent compliance has now been added to the Agreed Upon Procedures (AUP) audit, and it is very important that districts comply with the Signed Parental Consent and the Parental Notification requirements of the program. Along with the one-time signed consent, the program also requires that an annual MSP Parental Consent Notification be sent to all IEP Students. (See attached Form Letter) Keep in mind that the Medicaid Parental Consent requirements are a mandate from IDEA that has also been adopted in the Medicaid School Program.

The Parental Consent Notification provides parents with the following information:

• Brief description of the Ohio Medicaid School Program.
• Informs parents of their rights under IDEA.
• States that consent is voluntary and can be revoked at any-time.
• Explains that parents will not incur any out-of-pocket costs.
• Provides relevant Federal Code References.
• Asks them to call HBS with any questions.

The notification form can be distributed to parents in any method that you chose, and here are a few examples:

• Mail separately to each IEP parent.
• Include in beginning of the year packets.
• Distribute at each student’s Annual IEP Review.
• Email to each parent.
• Post Notification on school website.

Please inform HBS when and how you distribute the Parental Notification, and we will document your method in our system so it is available in the case of an audit. As you know, audits take place several years later, and we want to make certain that the information is available.

If you have any questions, please let us know.

Beginning with the 2015-16 school year, the Ohio Medicaid School Program will begin to reimburse school districts for “Specialized Transportation” for students on an IEP. Below are the conditions that must be met in order to receive Medicaid reimbursement for this new service.

• Specialized Transportation must be listed on the student’s IEP, and should state the medical reason why the student cannot ride on the standard bus route. Examples:
  • Student requires a wheel chair lift that is not on the standard route bus.
  • Student requires a seat belt or harness that is not on the standard route bus.
  • Student cannot step up onto a standard route bus.
  • Student requires air conditioning which is not on the standard route bus.
  • Student has behavioral issues and cannot ride on a standard route bus.
• Having a bus aide or nurse on the bus does not in itself make the transportation considered “Specialized” for MSP purposes. If a bus aide rides on the regular route, it is not considered MSP Specialized Transportation.
• “MSP Specialized Transportation” means that you have to make a special trip to and from the student’s home to pick them up because there is a medical reason why they cannot ride the regular bus that they would otherwise ride had they not had their medical condition.
• MSP Specialized Transportation can be provided on a School Owned Vehicle or can be provided by a Contracted Transportation Company. Paying the parent to transport the student is not reimbursable under the Ohio Medicaid School Program.
• Each Specialized Transportation trip that the district is seeking reimbursement for must be documented and include:
  • Student Name
  • Dates Transported
  • Signature of Individual Attesting to the Transportation

Documentation can be in the form of a log (attached sample) or invoices from the contracted transportation vendor.

• Send Specialized Transportation documentation to HBS on a monthly basis so that we can process accordingly.
• Transportation can only be billed on days that the student received another billable MSP service such as OT, PT, Speech, Psychology, Nursing, etc.

We are still working with ODE/ODM on the rate methodology, and it appears that we will be using cost data from the ODE T-I/T-II annual reporting to compute a “Rate per Trip” or “Rate per Student” for Cost Reporting purposes.

Please contact our office with any further questions regarding “MSP Specialized Transportation”.