2 Agenda Overview The Office of Medicaid Operations Claimable Medicaid ServicesMedicaid RequirementsParental Consent FormsPrinting the Consent FormFrequently Asked Questions from FamiliesCollecting Consent FormsComments and questions
3 OverviewNew York City can claim reimbursements from Medicaid when certain services have been provided to students and various requirements from both the state and federal government have been met. The Office of Medicaid Operations in collaboration with the Office of New School Design and Charter Partnerships are launching Medicaid reimbursement for services for Charter School Students.
4 Office of Medicaid Operations The Office of Medicaid Operations is responsible for the coordination of programmatic and administrative efforts to maximize claims for Medicaid reimbursements of related services for applicable areas, including Physical Therapy, Occupational Therapy, and Speech/Language Therapy. The Office works to find efficiencies to allow for increased Medicaid claims, and functions to ensure that claims submitted by the DOE meet state and federal requirements.
6 General Medicaid Requirements There must be a signed consent form from the family.There must be an order or referral documenting a medical necessity for the service.The service must be provided in accordance with the IEP.The service must be provided by a licensed and qualified service provider.There must be documentation of the provided service, including progress notes where applicable. This will be documented through encounter attendance in SESIS.
7 Parental Consent Forms Consent forms for students are available to be printed in ATS on the MEDL screen.Forms should be sent home with all students who have IEPs, regardless of Medicaid eligibility status.New regulations allow for a one time collection of a form instead of annual collection.After the first year where a consent form is signed, the institution needs to send out an annual written notification of the DOE’s intention to claim Medicaid. This letter will be provided via the Office of Medicaid Operations & DOE Charter School Homepage.
8 Parental Consent Forms (continued) Why does the form need to be printed from ATS?When a student’s form is printed from ATS it prints with a bar code that allows for simple electronic storage of both the form and the parent’s response.What if I do not have access to ATS?If you do not have access to ATS, please work with your school secretary- they can access the MEDL screen in ATS to print out a customized student form. The school secretary can also access the RSEM screen to determine the current consent status of a student and if a form needs to be printed, signed, and collected.Who should print the form and ask the parent/guardian to sign?Although we are requesting Charter School Special Education Coordinators to lead in this process, all staff who interact with the parents/guardians of students with IEPs can also assist. This includes:Parent CoordinatorsIEP Review Team MembersPrincipals and Assistant PrincipalsRelated Service ProviderSpecial Education Coordinators
9 Printing the Consent Form Medicaid Consent Letter - MEDLThis function is designed to allow a school to generate or regenerate a Medicaid Authorization letter. There are several options that you can use with this function:If you are generating the Medicaid Authorization Letter for your Special Education students for the first time in the current school year, put Y in the NEW STUDENTS/LTR NEVER PRINTED field and then press F6. All of the letters will be sent to the DFS Queue on hold unless you change the value in hold field to N (HOLD: N).If you have a particular student or students for whom you would like to generate letters, you can enter their ID numbers (or press F4 in that field for a lookup) and press F6 to send the letters to your printer.After the initial run, if you only want to generate letters for any new Special Education IEP students who have never had a letters generated, you can put a Y in the field: NEW STUDENTS/LTR NEVER PRINTED: Only students who have not yet had a letter generated will print. Please Note: If this is a transfer student and a letter had been generated at the previous school, a letter will NOT be generated.If you only want to regenerate letters for those students for whom no letter has been returned, you can put a Y in the field: LETTER NOT RETURNED
11 Frequently Asked Questions from Families Will signing the form impact my family’s Medicaid benefits? Are there any costs to me or my family?Signing the form will not impact a family’s Medicaid benefits.There is no cost to you or your family.There are no expenses, premiums, costs or co-payments.If your family receives Medicaid benefits, your coverage will not be canceled, the lifetime coverage in place will not decrease and services that your family receives will not be affected in any way by the accessing of Medicaid benefits.You will not risk the loss of eligibility for home and community based waivers, if any, that are based on your total health-related expenditures.Will not signing this form impact my child’s services that are on the IEP?The consent form has no impact on service provision to your child.The NYC DOE is obligated to provide the services on the IEP regardless of whether or not there is a signed Medicaid consent form.You will not be asked to sign up for or enroll in Medicaid for your child to receive the services on his/her IEP.
12 Frequently Asked Questions by Families (continued) Can I change my mind after I have signed a consent form?Yes, you can change your mind at any point.Contact your child’s school and ask that they print a new Medicaid consent form for your child. You can fill that new form out and return it to your child’s school.My family is not Medicaid eligible- do I need to complete the form?All families of students with IEPs are asked to complete this form, regardless of their Medicaid eligibility status.The form does not ask a family to identify their Medicaid eligibility status.
14 Verifying the Consent Form (continued) All information must be complete and accurate on the form in order for NYC to be eligible to receive reimbursement from Medicaid for student services. Schools should follow the steps below to ensure complete and accurate processing of the forms.As per the example on the previous slide, ensure ‘yes’ or ‘no’ field is completely filled in. If field is not selected, return to family to complete.Verify parent signature and date are complete. If signature or date is missing, or if the date is completed incorrectly, return form to the family to correct and resubmit.Once information has been verified, use a black or blue ink pen to fill in the bubble in the ‘signature and date verified’ field at the bottom of the form.
15 Collecting Consent Forms Beginning May 8th we are asking Special Education Coordinators or designated Charter School Staff to support the Office of Medicaid Operations in the collection of parental consent forms on a rolling basis. These forms can be returned to our office:MailOffice of Medicaid Operations52 Chambers Street, Rm 318New York, NY 10007(subject line: “Name of School – Consent forms”)Fax(please include cover page with the name of the school)
16 Questions and comments Inquiries to the DOE regarding Medicaid or the consent form may be directed to:The Office of Medicaid Operations