Medicaid

Student information Medicaid tools allow users to track insurance information, services provided to the student and a log of services.

Medicaid is a jointly funded, Federal-State health insurance program for low-income and needy people. The federal government provides broad guidelines for administering Medicaid funds, which means all states have the ability to implement Medicaid differently.

Each state administers its program, establishing eligibility standards, determining the type, amount, duration, scope of services and setting the rate of payment for services. Individuals are covered under Medicaid, not families.

See the Tool Rights article for descriptions of tool rights for this area.

Qualification for Medicaid Billing

In order for a school corporation to be able to bill for Medicaid-covered IEP services using the
school’s Medicaid provider number (NPI), the following requirements must be met:

  • The student must be enrolled in the state Medicaid Program
  • The student must qualify for special services under IDEA.
  • The student must have an IEP developed under the IDEA authority.
  • The Medicaid eligible services must be specified in the IEP.
  • The services must be rendered by a provider who meets Medicaid qualifications and who is qualified to provide the service under applicable state licensure or certification requirements.
  • The school corporation must obtain a signed release/consent form from the parent(s) in order to verify the student’s eligibility for Medicaid and to bill Medicaid for covered IEP health related services that are provided to the student.
  • The school corporation must bill other liable insurers first before billing Medicaid for these services.