[SE-Dir] School Medicaid Administrative Claiming

[SANDBERG Ruby]

TO:       All District and ESD Special Education Directors

The message below is being sent to you on behalf of:

Nancy Latini, PhD
Assistant Superintendent
Student Learning & Partnerships
______________________________________________
August 22, 2011


The following information was sent to me by Linda Williams of DMAP and I wanted to be sure you had it.  You may already have this information but just in case --- Thanks.

Nancy Latini



A coaches campaign, called "Get Covered, Get in the Game," in seven states includes Oregon. This sounds like an opportunity for more school districts and ESDs to participate in School Medicaid Administrative Claiming (MAC) for outreach to children.

Some school districts and ESDs have participated in MAC since around 2001.  Oregon's success for enrolling children into Medicaid is due to school districts voluntarily participating in this program and claiming reimbursement for outreach activities.

Please see the attached excel sheet that references school MAC reimbursements.

Also, note low performance amounts are due to a number of k-12 school districts that choose not to participate.

School MAC program targets K-12 population.

EI/ECSE population is targeted through Targeted Case Management.

Outreach under the School MAC program is matched 50/50.  50% local match provided by school districts and ESDs that participate and 50% federal match.  Outreach activities are performed at schools as opportunities occur and are captured through quarterly random time studies for one day each month for each quarter (excluding summer).

The process for the time studies use to be paper and thus many school districts found it to be cumbersome.  However, this is no longer the case.

Oregon has a statewide electronic data capture system for the time studies with built in edits and audits that make it cost and time efficient for Medicaid Administrative Claiming (MAC).

This system is utilized for school MAC as well as the public health department MAC programs.

Participation in school MAC is simple using time study one day per month per quarter for 3 quarters (summer is excluded) and doesn't have the documentation requirements like those for School-Based Health Services for the related services provided pursuant to an IEP or IFSP.











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