As a special education administrator, I oppose the proposed changes by the Department of Medical Assistance Services (DMAS) to the Virginia school-based Medicaid
reimbursement program. Specifically, the proposed changes that would
require a physician’s signature for each Plan of Care for nursing and
personal care services could force school divisions to discontinue billing for
these services. At best, these changes would create a significant amount
of additional work and cost for local school divisions. The requirement for a
physician’s signature for each Plan of Care may be difficult to obtain, and
will likely result in a decrease in reimbursement for these services. In
addition, complications of billing for nursing and personal care services
could impact school divisions’ transportation reimbursement, since billing
for transportation depends on other billable services.
A decrease in Medicaid reimbursement dollars and an additional cost to
school divisions for participating in the Medicaid reimbursement program is
of great concern. As the number of students with disabilities increased (by
24% in Virginia in the past four years), so did the complexities of students’
needs. Consequently, federal, state, and local education funding fails to
keep pace with the cost of providing special education, causing school
divisions to rely more and more on Medicaid reimbursement to off-set the
increasing costs of specialized instruction and related services.
We urge you to reconsider these proposed changes and allow the current
school-based Medicaid reimbursement program requirements to remain in
place.