If your district has a child placed at a facility that bundles the cost of health-related services into a flat tuition rate, those services may be reimbursable.
In most cases, MSB can pursue reimbursement for your district as long as:
- At the onset of a placement agreement, the district requests the facility to ensure that billable services will be recorded by the service provider(s), either through Lumea or transaction logs.
- The child is eligible for Medicaid.
- The IEP, ORRF and Parental Consent are in place.
- The service provider is properly licensed, or, in the case of out-of-state or non-DOE-certified mental health providers, a waiver is secured by the district.
- The OOD facility does not bill DHHS directly for health-related services.
Since transportation costs are only reimbursable for days during which a child receives a health-related, covered service, making sure that the above elements are in place can have a double impact on your Medicaid reimbursement.
If you have any questions, or would like to learn more, please contact your Program Specialist.