As Medicaid Coordinator for Fredericksburg City Public Schools, I appose the prosed changes by DMAS to the Virginia school-based Medicaid reimbursement program.  The proposed changes would require a physician signature for each Plan of Care for nursing and personal care services.  This change could force our division to stop billing for these services. This requirement would create and additional amount of work and cost for the school division. The signature for each Plan of Care may be difficult to obtain which would decrease reimbursement for these services.  The division mostly face additional costs as most Physicians now charge fees for paperwork.  These new changes would also effect school division transportation reimbursements as billing for transportation requires other billable services.

These changes would decrease Medicaid reimbursement amount and additional costs if a great concern.  The number of students with disabilities had increased greatly over the years as well as the students needs.  Federal, state and local funding are not able to keep with the funding needs which results in school division relying more on Medicaid reimbursements.

The proposed changed do not provide clarification or guidance for psych, nursing, personal care, and transportation.

I urge that the current school-based Medicaid reimbursement program requirements stay the same.