Medicaid Annual Notification

Billing Medicaid for Health-Related Services in Student’s Individualized Education Program (IEP) Annual Notification

Information and Answers for Families

Why are school districts billing Medicaid?
The Individuals with Disabilities Education Act
(IDEA) allows certain services provided under an Individualized Education Program (IEP) to be
covered by Medicaid. Medicaid funds help pay for the costs of providing these services.

What can school districts bill Medicaid for? School districts can only bill for health-related
services that are outlined in the student’s IEP. In general, services for which school districts may bill Medicaid are: hearing & vision services, nursing services, personal care services, assistive technology services, occupational therapy services, physical therapy services, speech & language therapy services, psychological services and psychotherapy counseling.

Do school districts need parental consent to bill Medicaid? Yes. Before billing Medicaid for
the first time, the school district must ask for your permission to bill your or your child’s public
benefits or insurance to pay for your child’s related services under the IDEA. School districts are required by the Family Educational Rights and Privacy Act (FERPA) to obtain parental consent before sharing information about a student. This includes sharing personally identifiable information about a student to Medicaid. To receive funding from Medicaid to help pay for the cost of services, the school district must have parental consent to bill Medicaid.

Can parents withdraw their consent to bill Medicaid? Yes. Parents have the right to
withdraw their consent at any time.

If consent is not given by parents to bill Medicaid, will their children still receive IEP
Yes. Districts are required to provide all IEP services, at no cost to parents, even if
the district cannot bill Medicaid. A school district may not require parents to sign up for or enroll
in public insurance programs in-order for their child to receive a free, appropriate education
under IDEA, Part B.

If school districts bill Medicaid, will Medicaid services that parents or guardians receive
outside school be affected?
No. Medicaid services received outside school and the child’s IEP are authorized separately. The district may not use your child’s benefits under a public benefits or insurance program if that use would result in a decrease of any other insured benefit; result in the family paying for services that would otherwise be covered by a public benefits or insurance program and that are required for the child outside of time the child is in school; result in discontinuation of coverage; or result in the risk of loss of eligibility for home and community based waivers based on aggregate health-related expenditures.

Are school districts required to notify parents? If so, how often must parents be notified? As
the parent or guardian of a student who has or may have a disability, you have certain rights
under federal and state law. Your child’s school district must provide you with written notification of these rights regarding parental consent prior to accessing your public benefits or insurance for the first time and annually thereafter. This document serves as your written notification.

Where can parents get more information about this? The US Department of Education