Notification & Consent for Medicaid Reimbursement

This page outlines the process that requires schools to obtain parental consent before billing Medicaid for certain services provided to children with disabilities. This process is designed to ensure that parents are fully informed about the services for which Medicaid reimbursement is being sought and that they have given explicit consent for the school to bill Medicaid for those services.

Notification Regarding Access to Public Benefits and Consent for Medicaid Reimbursement

1. Select a student on the Students panel.

2. Click the Documents icon for the student.

3. From the Create New Document drop-down list, select Notification & Consent for Medicaid Reimbursement under Special Education Notices, and click Go.

4. Enter a Label/Comment and click New. Click Additional Settings to specify the year and sections to include.

5. In the Student Information section, the system auto-populates the following information:

   • From the Student Info/Demo Part B profile: 

     • Student

     • USI

     • DOB

   • From the LEA Entry/Exit Part B profile:

     • Grade

   • From the Special Education Part B profile:

     • Case Manager

     • Last Eligibility Meeting Date

6. The system auto-populates the parent or guardian names that have Educational Rights selected in the Student Contacts Part B profile. The user can choose the parent or guardian who wants to sign.

   • The system provides three checkboxes to confirm the parent's or guardian's consent. When the parent or guardian signs digitally, they can select only one checkbox.

   • The system displays the following information:

     • From the Student Info/Demo Part B profile:

       • Student Name

       • Student Local ID

       • Student State ID

     • From the Medicaid Part B profile:

       • Student Medicaid ID

     • From the LEA Entry/Exit Part B profile:

       • Local Education Agency Name

   • In the Parent/Guardian Signature area, a parent or guardian signature will appear through the digital signature functionality unless the user selects Parent/Guardian will sign a paper copy checkbox.

   • In the Date area, the signature date will auto-populate when the parent or guardian signs digitally.

7. When the parent, guardian, or student signs on paper, select the Parent/Guardian will sign a paper copy checkbox. When the checkbox is selected, the Document Delivery section is then required.

8. Click Save, Done Editing.

9. Finalize the document when completed. To finalize the document, click Set Document, select Status from Draft to Final, and then click Accept.

The header of the page displays the Office of the State Superintendent of Education (OSSE) and its address.

Document Delivery

This section is only required when the user selects Parent/Guardian will sign a paper copy checkbox. The section does not print.

1. Within the Notification & Consent for Medicaid Reimbursement document, navigate to Document Delivery using the flyout menu.

2. Select the Mode of Delivery.

3. Enter a date manually or select a date using the calendar icon in the Date of Delivery field.

4. Select the Parent Consent.

5. Enter a date manually or select a date using the calendar icon in the Parent Consent Date field.

6. Click Save, Done Editing.

Data Flow

Upon finalization of the documents, the following data flow occurs: