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View Full Version : Grrrr-School and Medical assistance?


Kate
02-13-2010, 03:55 PM
I don't know how many states do this-but could use some insite if yours does.

Our school is able to bill medical assistance if the parent agrees-you have to sign something. THey can bill for things like speech services, Pt, ot,...blah blah. Anyway-we have to pay out of pocket for Mitchell's MA (medicaid basically) because of our income level. We've always been careful about what we use MA for because of this. Because if we don't use as much as we pay...then we get money back or we don't get charged as much next year. SO-I've never let the school bill...even though they have said that it doesn't have anything to do with Mitchell's private MA. (which I know I should've gone w/my gut because if it didn't have anything to do w/it..why do we have to sign off??) ANYWAY, so this year I said...ok...maybe I"m just being to tight and obsessive about this and if they say that it doesn't affect his MA...and the school is really hurting for money...why wouldn't I sign...I went ahead and signed. WELL....I just got an explanation of ben. from MA and you'll never guess what's on it?! $400 worth of payments from MA to the school and home care...well we aren't using homecare anymore so we really shouldn't have any bills on there for that?? So that makes me wonder if the school is having the agency put it through MA?? Which isn't how it should work. I'm hoping I'm getting all worked up for nothing but it isn't looking good. Is it a huge deal-ah yes and no. No because actually this year because of building the house and some money loss we don't have to pay-YES because this means the school is lying or not realizing they are lying.

Anyone's school have this and if so maybe you can explain it better? I'll be calling his teacher as soon as their break is done. :mad:

drct1245
02-13-2010, 04:52 PM
Our school does this, but Ayden is pure Medicaid, so we don't pay anything and we never see an EOB since Medicaid is secondary. To me, it's like robbing peter to pay paul - it's one state agency to another. not much help to ya.

Ann
02-13-2010, 04:59 PM
Our school district does it as well and I always refused to sign the form. School districts are notorious for trying to pass the buck and I won't be part of it. I think it's completely wrong that they can bill Medicaid for services they are supposed to provide.

Katie - I'm not sure the teacher will be much help. You might want to go directly to the district special ed office and consider withdrawing your consent to bill Medicaid.

Kate
02-13-2010, 05:43 PM
Katie - I'm not sure the teacher will be much help. You might want to go directly to the district special ed office and consider withdrawing your consent to bill Medicaid.

ya-I'm not even going to bother with the teachers except to inform them that they might want to be careful how they explain this. I KNEW that this wasn't a good idea....just another reason to go with your gut...no harm done, but grrrr.

I will be telling them that I'm taking back my consent. grrrr:mad:

lynn
02-13-2010, 07:52 PM
Our district bills as well.. and I dont have to pay for Josephs medicaid; but have not signed off on it because if he was a typical student having trouble with speech, ect... then they would be providing it for him and it would be paid for out of the district budget (which is one of the reasons I pay school taxes)

TaraB
02-13-2010, 08:33 PM
I remember that a few years ago we (teachers) went to a meeting to learn how to fill out the forms to do this. My Para spent countless hours (even off the clock) documenting and calculating hours for reimbursement...come to find out our district never submitted any of the documentation to the state. Since then I have not documented anything--I have enough to do with compiling and charting goal data for IEP's...

One of my friends (and a co-worker) said that she refused to sign off on the form because she didn't think it was right for the school to "benefit" from her child's disability. I could totally see her point. Now, having a special needs child (or two) of my own, I think that I would not sign as well.

Good luck. I agree that you should contact your district's director of special education. The teacher will probably be glad to have one less to document on! :p

Ainsley's Mom
02-13-2010, 09:26 PM
Katie, is there not a Medicaid waiver program in Minnesota for the medically intensive? After the first year (Medicaid for hospitalization over one month) we were denied Medicaid through the regular channels and told we would have to be on the step down program due to our income. But we were able to get on this waiver program. I had to get to the right person and they came out and interviewed us and we had a lot of paperwork to fill out. Kids with trachs and vents qualify as medically intensive due to the care required. But the more stuff like G-tubes, meds, treatments, etc the easier the case. I don't want to give you false hope if that doesn't exist in your state but it might be something to check into. It really helps.

kadiera
02-13-2010, 09:36 PM
Katie, is there not a Medicaid waiver program in Minnesota for the medically intensive? After the first year (Medicaid for hospitalization over one month) we were denied Medicaid through the regular channels and told we would have to be on the step down program due to our income. But we were able to get on this waiver program. I had to get to the right person and they came out and interviewed us and we had a lot of paperwork to fill out. Kids with trachs and vents qualify as medically intensive due to the care required. But the more stuff like G-tubes, meds, treatments, etc the easier the case. I don't want to give you false hope if that doesn't exist in your state but it might be something to check into. It really helps.


In Michigan, the waiver comes with a sliding-scale annual fee. If you qualify for regular medicaid, it's free. Last year, the maximum fees were $2400 a year (payable in a lump sum) - I've heard it's going up considerably this year. Because Alexander was in-patient, he was medicaid eligible, so it cost us nothing. Sooner or later they'll decide he isn't and then we'll be paying the max, but it's worth it for us.

We got a letter from the school this week about the same sort of thing - they've stated that the schools here are not told who gets medicaid and who doesn't, so they ask all parents to fill out the form so they can send the bill and hope they get paid.

Ainsley's Mom
02-13-2010, 09:41 PM
In Michigan, the waiver comes with a sliding-scale annual fee. If you qualify for regular medicaid, it's free. Last year, the maximum fees were $2400 a year (payable in a lump sum) - I've heard it's going up considerably this year. Because Alexander was in-patient, he was medicaid eligible, so it cost us nothing. Sooner or later they'll decide he isn't and then we'll be paying the max, but it's worth it for us.

We got a letter from the school this week about the same sort of thing - they've stated that the schools here are not told who gets medicaid and who doesn't, so they ask all parents to fill out the form so they can send the bill and hope they get paid.

It's the same way in WA, we were denied unless we did the step down program and paid based on our income and it was a lot of money. What we eventually got on was a waiver program for the medically intense, you have to know about it and apply for it outside of the regular channels. They do not advertise it and most of the employees don't even know about this. They certainly didn't tell us. I'm hoping there might be a program like that in MN that you guys don't know about. Many states have them. At least I think they do. WA is not all that progressive about providing for it's citizens.

Kate
02-13-2010, 10:03 PM
Katie, is there not a Medicaid waiver program in Minnesota for the medically intensive? After the first year (Medicaid for hospitalization over one month) we were denied Medicaid through the regular channels and told we would have to be on the step down program due to our income. But we were able to get on this waiver program. I had to get to the right person and they came out and interviewed us and we had a lot of paperwork to fill out. Kids with trachs and vents qualify as medically intensive due to the care required. But the more stuff like G-tubes, meds, treatments, etc the easier the case. I don't want to give you false hope if that doesn't exist in your state but it might be something to check into. It really helps.

Thanks-I know that we did go through that to do a waiver, but we were told that we had to be on TEFRA (MA) in order to get it. Maybe there is something different though. It really is an outrageous amount...but, it has always been worth it because we used so much w/nursing care so if we didn't have it-we'd be paying more out of pocket. Now that we're During at Mayo-they are out of network for primary insurance, so MA is picking up the slack....which if he needs surgeries in the future-will be quite a bit. I'll have to look up some things. I know that all wavers right now are getting cut down-I'm concerned that MA will be doing the same. LIke many states..MN is in the hole (big time).

TommysDad
02-14-2010, 10:57 PM
I know you already got your answer, but just thought I'd share that our state has a similar form, too. Our school district tried to get us to sign a form to bill our insurances, too! We refused!

It's against the law for school districts to make families provide payments for any part of a child's IEP. PERIOD!!! But hey, if you'll sign that form, they'll take your insurance payments!!! You also have the right to revoke that contract at any time!!! And by law, before you ever sign that paper, they are supposed to tell you that by signing it, that can affect your child's life-time max on insurance benefits. Why? BECAUSE THEY ARE BILLING YOUR INSURANCE!!!

~Maggie

angelbaby
02-15-2010, 11:24 AM
we always sign off on that too, but i swear at one of kids lat iep meetings, not sure which kid, they are different districts,that it wasn't even option anymore to check yes or no, it was if you had it or not and if you did you provide the info and the district will bill medicaid, we don't have medicaid, so it doesn't matter at this point, but we are the waiver waitlist,so if/when we get on the waiver, i am not sure how it will work.