Legal Clips, [September 2007]Maryland officials say a recent decision by federal Medicaid administrators to stop reimbursing states for the cost of transporting disabled students to and from school is part of a "mean-spirited," months-long trend to "dump additional costs onto the states." The change would hit Baltimore City and Prince George's County the hardest: Baltimore billed Medicaid for $593,503 in fiscal 2007 for special-needs transportation and Prince George's County billed for $106,560, says Bill Reinhard, a state Department of Education spokesman. While many schools in the state decline to seek Medicaid assistance because of the paperwork involved, the statewide total reimbursement for student transport in fiscal 2007 was about $1 million, officials say. Now, the state and the jurisdictions that do bill Medicaid are "going to have to pick up the tab for it," says Maryland Disabilities Department Secretary Catherine A. Raggio. She says notification of the change was "mean-spirited," because it was e-mailed to state officials late on the Friday before the Labor Day holiday. That followed another cut in Medicaid assistance that was announced late on a Friday two weeks earlier.
The student transport announcement declared that getting disabled children to school would be re-classified as an administrative cost, not a covered medical expense, and therefore could not be billed to Medicaid. Federal officials said the change is an effort to cut back on waste and fraud, claiming it would save taxpayers $3.6 billion over the next five years. Billing Medicaid for general transportation costs—rather than strictly for medical services—is a "pervasive problem" among school jurisdictions nationwide, says Mary Kahn, a spokeswoman with the Centers for Medicaid and Medicare Services (CMS), which announced both cuts. She says Medicaid will continue to pay for specific services required during a student's journey to and from school, such as an oxygen tank or a special seat. Officials could not say how many Maryland children would be affected by the bus cuts. Those cuts will have a relatively small financial effect on Maryland, but state Medicaid director John Folkemer points to other examples of Medicaid tightening its reimbursement rules for state programs. "All of these changes compounded make it difficult for states to meet the needs of their students," says Ms. Reggio.
Southern Maryland Online By Andy Zieminski (Capital News Service)
[Editor’s Note: Details on the proposed regulations, the federally mandated services affected, and the history of the long-running struggle are available starting from the first link below. The House-Senate conference report of the State Children’s Health Insurance Program Reauthorization Act of 2007 (SCHIP) would prevent the U.S. Department of Health and Human Services from restricting Medicaid reimbursement for school-based services until May 28, 2008. See additional resources and letters to Congress from NSBA’s Office of Advocacy at the second link.]
NSBA School Law pages on CMS proposed regulations
NSBA Office of Advocacy Medicaid Reimbursement page