Parental Notice for Billing Medicaid
for Health-Related Services in Student’s Individualized Education Programs (IEP)
This is the notification of your rights under the Individuals with Disabilities Education Act (IDEA) regarding Medicaid billing. IDEA allows certain services provided under an IEP to be covered by Medicaid. The Wisconsin Medicaid school-based services benefit is a way for school districts to receive additional federal revenue. These services include attendant care services, nursing services, physical therapy, occupational therapy, speech and language services, specialized medical transportation, psychological services, counseling, social work services, and developmental testing and assessment.
In order for a school district to request these funds, you, as the parent, must be notified of your rights under IDEA regarding this process. After notification and before a school district may seek recovery of costs, you must sign a consent form that gives the school district permission to bill Medicaid and share student information. This notice is not consent for the school district to bill Medicaid, which is a separate form signed after you have received this notification.
The following rights are afforded to parents regarding Medicaid billing under IDEA:
1) A district must obtain your written consent prior to submitting your child’s IEP-health-related costs for Medicaid reimbursement. Consent only needs to be provided once, so you will not have to sign the form each year.
2) The consent form allows the school district to send your child’s education information to Wisconsin’s Department of Health Services (DHS), the state agency that administers Medicaid. The consent form lists the education records that may be shared with DHS.
3) At any time you decide that you do not want the school district to share your child’s information with DHS or to bill Medicaid for your child’s costs, you can withdraw consent and the school district will no longer include your bill for Medicaid.
4) School districts are required to provide all IEP services at no cost to parents even if the district cannot bill Medicaid. Parents are not required to sign up for or enroll in public insurance programs in order to receive these services.
5) As a student with a disability, your child will always receive a free appropriate public education (FAPE) while attending a public school regardless of insurance coverage. The school district will never require you to enroll in Medicaid to ensure your child receives FAPE.
6) The school district will never require you to pay for a deductible or co-pay if one is created when the Medicaid bill is filed by the school district.
7) Billing Medicaid for a cost:
a. Will not decrease the availability or length of Medicaid coverage time for your child,
b. Will not result in you paying for required services outside of school that would have been covered by Medicaid,
c. Will not increase your insurance premiums or lead to the discontinuation of benefits or insurance, and
d. Will not risk your child’s eligibility for home and community-based waivers, based on the total costs of your child’s health-related needs.
School districts are strongly encouraged to access Medicaid for student costs as it brings more federal revenue into Wisconsin. If you have not signed a “Consent to Bill Wisconsin Medicaid for Health-Related Special Education and Related Services” form, the school district will be contacting you with a request to sign the form so that Medicaid billing may begin. If you have signed a consent form in the past, this serves as an annual notification to remind you of your rights under IDEA and to stress that accessing Medicaid on behalf of your child does not reduce any of the benefits that you would normally receive under the Medicaid program outside of the school day.
