School Based ServicesMedicaid is a jointly funded Federal and State health insurance program for persons with low income and/or disabilities. School Based Medicaid Services allows reimbursement under the Medicaid program for services administered to students with special needs under the Individuals with Disabilities Education Act (IDEA) and is administered through the Van Buren Intermediate School District. Under IDEA, public schools can receive partial reimbursement for medically necessary services provided to Medicaid eligible special education students. Although partial reimbursement is available for students who are Medicaid eligible, services are provided to students with disabilities regardless of their Medicaid eligibility status.School Based Services DO NOT affect Districts are required to notify the family of children who qualify for special education services and obtain consent prior to requesting reimbursement from Medicaid. The School Based Medicaid Services Program is designed to ensure that eligible children who receive special education services have access to needed health care.
Fee For Service Program
Coverage applies to individuals up to the age of 21 who are eligible under the provisions of the Individuals with Disabilities Education Act (IDEA) of 1990 as amended in 2004 and to those enrolled in programs that require an Individualized Education Program (IEP) or an Individualized Family Services Plan (IFSP).
Partial reimbursement applies to the following services:
Direct Medical Services
- Occupational Therapy Services
- Orientation and Mobility Services
- Physical Therapy Services
- Social Work Services
- Speech, Language and Hearing Services
- Nursing Services
Targeted Case Management
Targeted case management services are services furnished to assist individuals in gaining access to needed medical, social, educational or other services. The case manager is the person responsible for the implementation of the plan of care/treatment plan.
Personal Care Services
Personal Care Services are a range of human assistance services provided to persons with disabilities and chronic conditions which enables them to accomplish tasks that they would normally do for themselves if they did not have a disability.
Medicaid may reimburse for special education transportation when a beneficiary receives a Direct Medical Service on the same day. Special Education specialized transportation services include transport to and from the beneficiary's pick-up and drop-off site where Medicaid services are provided.
Administrative Outreach Program
The School Based Services Administrative Outreach Program offers partial reimbursement for the cost of administrative activities that support efforts to identify and enroll potentially eligible persons into Medicaid and that are in support of the state Medicaid plan.
These activities fall into several categories:
- Medicaid Outreach
- Facilitating Medicaid Eligibility determinations
- Health-related Referral Activities
- Medical Service Program Planning, Policy Development, and Interagency Coordination
- Programmatic Monitoring and Coordination of Medical Services
- Transportation and Translation Services