On January 25, 2011 the National Alliance for Medicaid in Education, Inc. (NAME) hosted a national conference call to review the results of the NAME 2009 Biennial Survey Trends and Data. Over 80 individuals participated in the conference call including representatives of school districts, state Medicaid and education agencies, the Office of Special Education Programs (OSEP), Centers for Medicare and Medicaid Services (CMS), Council of Administrators of Special Education (CASE), American Association of School Administrators (AASA) and National Association of State Directors of Special Education (NASDSE). The purpose of the Biennial Survey is to obtain data to identify trends in school-based Medicaid direct service billing and Medicaid administrative claiming (MAC).
To obtain appropriate data, NAME distributed a Survey Monkey to state Medicaid and education agency contacts in 50 states. Agencies within each state were allowed to submit data individually or jointly. Twenty-eight states responded to the survey. NAME analyzed the data submitted and prepared a PowerPoint presentation reflecting its findings using aggregated data. According to the presentation, overall Medicaid reimbursement has declined sharply since 2005; however, several states reported overall increases in reimbursement. The NAME presenter speculated that the drop in reimbursement was due to the implementation of the 2003 CMS Medicaid School-Based Administrative Claiming Guide. Survey participants identified obtaining accurate service documentation and parental consent as the biggest obstacles for optimal direct service billing. The time study participant selection and methodology were identified as the biggest obstacles for optimal MAC. A copy of the NAME presentation can be accessed from the NAME website http://www.medicaidforeducation.org/ and clicking on “Topical Calls.”
About Patsy Crawford
Patsy Crawford, Director of Legal Services, PCG Education, has over 30 years of legal experience and is responsible for providing legal and regulatory compliance support to the PCG Education management team. Since joining the firm in 1997, Patsy has worked closely with school district administrators and PCG Education managers and consultants to coordinate with state and federal Medicaid agencies to protect and improve billing programs for school districts. She has provided direct legal support to PCG Education projects in multiple states across the country.
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