Director of Special Education for Fredericksburg City Public Schools, I oppose the proposed changes by the Department of Medical Assistance Services (DMAS) to the Virginia school-based Medicaid reimbursement program.  The proposed changes that would require a physician’s signature for each Plan of Care for nursing and personal care services would force our school division to discontinue billing for these services. The 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.  This requirement could also result in costs to the school division as many physician’s offices now charge fees for paperwork completion. Additionally, these changes of billing for nursing and personal care services could impact school divisions’ transportation reimbursement, since billing for transportation depends on other billable services. 

These changes would decrease Medicaid reimbursement dollars and add additional costs to school divisions for participating in the Medicaid reimbursement program is of great concern.  The number of students with disabilities has increased significantly over the years as well as the student needs. Federal, state and local funding is not able to keep up with cost of providing Special Education needs which results in school divisions relying more on Medicaid reimbursements.

The proposed changes to the manual do not provide clarification or guidance for psych, nursing, personal care, and transportation.

Time and services used to track all of this paperwork will affect the monies that would be used to benefit the students could ultimately result in school divisions discontinuing the billing of nursing, personal care, psych, and transportation.

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