Appendix F. Exceptions to School Districts Claiming Medicaid Reimbursement for Certain Eligible Services

Transcription

1 Appendix F Exceptions to School Districts Claiming Medicaid Reimbursement for Certain Eligible Services

2 EXCEPTIONS TO SCHOOL DISTRICTS CLAIMING MEDICAID REIMBURSEMENT FOR CERTAIN ELIGIBLE SERVICES A school district may claim Medicaid reimbursement for any eligible IEP service, evaluation and any TCM service provided by the school district to any student with a disability with the following exceptions: 1. The student placed full time and receiving services in an Article 28 Facility- * The Article 28 facility is approved to bill Medicaid directly for school age students. The Medicaid funds derived from these services are reported to SED and the Tuition rate is reduced by that amount. 2. The Office of Mental Retardation and Developmental Disabilities (OMRDD) places the child in an Intermediate Care Facility (ICF) in your district. The district may not claim Medicaid reimbursement for any related services provided these students since the SED reimburses 100% of the costs to educate these children including transportation. SED claims the Medicaid reimbursement for these services. However, the school district may claim reimbursement for any evaluations and any TCM services provided these students. 3. A school district may not claim Medicaid reimbursement for any eligible service that they pay for with Federal funds, i.e., IDEA funds. * The student who is not placed in the Article 28 facility full time but receives only related services from the staff at that facility. The school district may claim Medicaid reimbursement for these services. The facility may not. NOTE: OMRDD has converted some ICF's residences to an Individual Residential Alternative (IRA) or initially opened a new residence as an IRA. If a child resides in an IRA the school district is entitled to claim Medicaid reimbursement for all eligible services provided that child. Other than the above exceptions, if a school district pays for the delivery of eligible services, they may claim Medicaid reimbursement. If you have any questions please contact Robert J. Scalise at 518: or at rscalise@mail.nysed.gov. F-1

3 ARTICLE 28 FACILITIES APPROVED TO CLAIM MEDICAID FOR ELIGIBLE SERVICES UNDER PSHSP (Revised 8/2006) Thomas Mohr Vice President of Finance Buffalo Hearing & Speech Center (ONLY FOR PRESCHOOL CENTERBASED PROGRAMS AND ONE INTEGRATED SETTING SITE (SHERIDAN PARKSIDE) 50 E. North Street Buffalo, NY Richard M. Hansinger Executive Director E. John Gavras Center Cerebral Palsy Association of Cayuga County 182 North Street Auburn, NY Donald L. Gerrish Associate Executive Director United Cerebral Palsy of New York City, Inc. 80 Maiden Lane, 8 th Floor New York, NY Greg Sorrentino Chief Financial Officer Center for the Disabled 314 South Manning Boulevard Albany, NY Edward Handschumaker, Jr. Chief Finance Officer Aspire of Western New York (UCP) 2356 North Forest Road Getzville, NY Mark S. Peters Executive Director Cerebral Palsy and Handicapped Children s Association of Chemung County (ONLY FOR PRESCHOOL STUDENTS IN AN INTEGRATED SETTING PROGRAM) P.O. Box Charles Street Elmira, NY F-2

4 ARTICLE 28 FACILITIES APPROVED TO CLAIM MEDICAID FOR ELIGIBLE SERVICES UNDER SSHSP (Revised 1/2006 and 4/2006) Greg Sorrentino Chief Financial Officer Center for the Disabled 314 South Manning Boulevard Albany, NY Donald L. Gerrish Associate Executive Director United Cerebral Palsy of New York City, Inc. 80 Maiden Lane, 8 th Floor New York, NY Edward Handschumaker, Jr. Chief Finance Officer Aspire of Western New York (UCP) 2356 North Forest Road Getzville, NY H. Patrick Bennett* Prospect Child and Family Center 133 Aviation Road Queensbury, NY * Bills Medicaid for Related Services Only. Note: Buffalo Hearing and Speech Center no longer claims Medicaid directly for the SSHSP program.

5 F-3 BEDS CODE INTERMEDIATE CARE FACILITIES [ICF's] SCHOOL AGE PLACEMENTS ONLY UCP - CAPITAL DISTRICT O.D. HECK DVLPMNTL CTR - AUTISM PROG REHABILITATION SERVICES BROOME DVLPMNTL CTR CATHOLIC CHARITIES CATTARAUGUS REHAB CTR RESOURCE CENTER (THE) ARC INC CHEMUNG CO CHAPTER DAY TRAINING CTR (REHABILTATION PROG) CARDINAL HAYES SCHOOL FOR SPEC CHLDR UCP OF WESTERN NY BAKER VICTORY SVCS CTR AUTISTIC SERVICES INC ERIE COUNTY NYS A.R.C DDSO WESTERN NEW YORK ARC FRANKLIN CO SUNMOUNT DEVELOPMENTAL CENTER NYS FOR THE BLIND MONROE DVLPMNTL CTR MARY CARIOLA CHILDRENS CTR LIFETIME ASSISTANCE ICF ARC MONTGOMERY MENTAL HEALTH ASSOC OF NASSAU CNTY NASSAU/SUFFOLK SVCS - AUTISTIC LITTLE VILLAGE HOUSE METRO NEW YORK DDSO UCP OF NYC COMMUNITY RESOURCE CENTER - WM A B HEART SHARE HUMAN SVCS MERCY HOME FOR CHILDREN BROOKLYN DVLPMNTL CTR JEWISH BD FAM & CHILD SER-CAMP MISH UCP NYS REGION II # BERNARD FINESON DVLPMNTL CTR WORKING ORG/RETARDED CHILDREN BIRCH SCHOOL FOR EXCEPTIONAL CHLDRN THERESA PAPLIN / ST CHRISTOPHER OTTI STATEN ISLAND DDSO UCP OF NIAGARA CO, INC DDSO CENTRAL NEW YORK

6 F-4 BEDS CODE INTERMEDIATE CARE FACILITIES [ICF s] TOOMEY RESIDENTIAL & COMMUNTIY SRVS DDSO FINGER LAKES KIRYAS CTR FOR DVLPMNT DISABILITIES UPSTATE HOME FOR CHLDRN RAINBOW PROJECT ST AGATHA HOME FOR CHILDREN LETCHWORTH VILLAGE DDSO (Abbott House) ARC ST LAWRENCE CO NYSARC, INC PINE ARC SARATOGA ARC STEUBEN DDSO LONG ISLAND SAGTIKOS EDUCARE ARC SUFFOLK COUNTY UCP ASSOC GREATER SUFFOLK INC FRANZISKA RACKER CENTERS INC ARC WARREN/WASHINGTON CO ARC WAYNE COUNTY CHAPTER INC WESTCHESTER DEV. CTR. (Abbott House) COMMUNITY BASED SERVICES, INC RICHMOND CHILDRENS CENTER NOTE: All ICF Summer Placements Are Chapter 721 NOT Section 4408 Placements. BEDS CODE CHILDREN S RESIDENTIAL PROGRAMS & ICF S ANDERSON SCHOOL * DEVEREUX UCP OF UTICA * MARYHAVEN DEVELOPMENTAL DISABILITIES INSTITUTE (DDI) UCP SULLIVAN DIAGNOSTIC TREATMENT CTR. * UCP OF ULSTER Note: * These facilities also contain ICF programs. F-5