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Sunday, July 26, 2020 | History

3 edition of Medicaid, questionable practices boost federal payments for school-based services found in the catalog.

Medicaid, questionable practices boost federal payments for school-based services

William Scanlon

Medicaid, questionable practices boost federal payments for school-based services

statement of William J. Scanlon, Director, Health Financing and Public Health Issues, Health, Education, and Human Services Division, before the Committee on Finance, U.S. Senate

by William Scanlon

  • 67 Want to read
  • 36 Currently reading

Published by The Office in Washington, D.C. (P.O. Box 37050, Washington 20013) .
Written in English

    Subjects:
  • United States. -- Health Care Financing Administration.,
  • Medicaid -- Finance.,
  • Medicaid -- Costs.,
  • School districts -- United States -- Costs.,
  • School children -- Medical care -- United States -- Costs.

  • Edition Notes

    StatementUnited States General Accounting Office.
    SeriesTestimony -- GAO/T-HEHS-99-148.
    ContributionsUnited States. General Accounting Office.
    The Physical Object
    FormatMicroform
    Pagination16 p.
    Number of Pages16
    ID Numbers
    Open LibraryOL15549322M

    Government Begins Investigating School District Medicaid Billing Questionable Practices Boost Federal Payments for School-Based Services, Statement of William J. Scanlon, Director, Health Financing and Public Health Issues, Health, Education, and Human Services Division, General Accounting Office, GAO/T-HEHS (J ) http.   Medicaid: Questionable Practices Boost Federal Payments for School-Based Services (June ) Medicaid: Intergovernmental Transfers Have Facilitated State Financing Schemes ( Author: Conn Carroll.

    Options for Sustaining School-Based Health Centers Questionable Practices Boost Federal Payments for School-Based Services. improprieties in Medicaid claims for school-based health. Federal Requirements and State Options: Provider Payment. States have considerable flexibility to design their own Medicaid payment methods and set their own payment rates (Table 1). States make direct payments to providers under fee-for-services arrangements; they make capitation payments to managed care Size: KB.

    Medicaid Reimbursement in School-Based Health Centers: State Association and Provider Perspectives A report of the National Assembly on School-Based Health Care, June School-based health care is most often distinguished as a comprehensive package of services—typically encompassing the fullFile Size: KB. School-based services are health-related and rehabilitative services provided to children with disabilities who receive services under the Individuals with Disabilities Education Act (IDEA).These services are provided by school districts, and charter schools and are considered medically necessary for children to participate in their educational program.


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Medicaid, questionable practices boost federal payments for school-based services by William Scanlon Download PDF EPUB FB2

Medicaid: Questionable Practices Boost Federal Payments for School-Based Services T-HEHS Published: Publicly Released: Medicaid: Questionable Practices Boost Federal Payments for School-Based Services: T-Hehs [U.

Government Accountability Office (] on *FREE* shipping on qualifying offers. The U.S. Government Accountability Office (GAO) is an independent agency that works for Congress. The GAO watches over Congress. Medicaid: Questionable Practices Boost Federal Payments for School-Based Services Background Under Medicaid’s federal-state partnership, states operate their Medicaid programs within broad federal requirements and can elect to cover a range of optional populations and benefits.

As a result, Medicaid is essentially Medicaid: Questionable Practices Boost Federal Payments for School-Based Services. Statement of William J. Scanlon, Director Health Financing and Public Health Issues, Health, Education, and Human Services Division.

Testimony before the Committee on Finance, U.S. by: 2. Get this from a library. Medicaid, questionable practices boost federal payments for school-based services: statement of William J. Scanlon, Director, Health Financing and Public Health Issues, Health, Education, and Human Services Division, before the Committee on Finance, U.S.

Senate. [William Scanlon; United States. General Accounting Office.]. 1See Medicaid: Questionable Practices Boost Federal Payments for School-Based Services(GAO/T-HEHS, J ). 2Bundled rates are single payments for a package of various services that eligible special education children may need over a specified period of time; a fixed amount is paid per child on the basis of the.

The Federal Medicaid program encourages states to use funds from their Medicaid program to help pay for certain health care services that are delivered in the schools, providing that federal regulations are followed.

For many children, schools are the primary point of entry to receiving needed health and social services. used by states and school districts to boost federal payments for school-based services.6 As part of our body of work on Medicaid financing issues, today we are releasing a report, undertaken at the Chairman’s request, that addresses states’ use of contingency-fee consultants to maximize federal Medicaid reimbursements Medicaid Payment for School-Based Services Speech-language pathologists and audiologists express concerns about the proper billing of Medicaid for their services provided to children in schools.

The following information and resources were developed to provide information related to Medicaid payment for school-based services. School-based services for children with disabilities.

Sincestates have been able to draw down federal funds under Medicaid to pay for school -based health and related services required by IDEA, when provided to Medicaid-eligible children with disabilities. CRS-2 1 Personal communication with CMS officials, Novem 2 See Medicaid Questionable Practices Boost Federal Payments for School-Based Services.

Testimony by William J. Scanlon before the Senate Finance Committee on J (GAO/T-HEHS), and Medicaid in Schools: Poor Oversight and Improper Payments Compromise Potential Benefit.

Medicaid: Questionable Practices Boost Federal Payments for School-Based Services. for reimbursement. My comments are based on information collected over the past 2 months, at this Committee's request, when we interviewed the 18 states identified as.

Inspector General (OIG), Office of Audit Services’ (OAS) report entitled, “Medicaid Payments for School-Based Health Services, Boston, Massachusetts -July through June ” A copy of this report will be forwarded to the action official noted below. Figures Figure 1: States Reporting Medicaid Claims for School-Based Services, December 13 Figure 2: Medicaid School-Based Administrative Claims for 10 States, Fiscal Years 1See Medicaid: Questionable Practices Boost Federal Payments for School-Based Services (GAO/T-HEHS, J ).

B The purpose of the Medicaid School-Based Administrative Claiming Guide (referred to hereafter as the Guide) is to inform schools, state Medicaid agencies, and other interested parties on the appropriate methods for claiming federal reimbursement for the costs of Medicaid administrative activities performed in the school setting.

United States. Senate. Committee on Finance. Title(s): Medicaid: questionable practices boost federal payments for school-based services. Testimony before the Committee on Finance, U.S. Senate/ W. Scanlon. Financing, Government/legislation & jurisprudence; Humans; Medicaid*; Reimbursement Mechanisms; School Health Services*; School.

• Medicaid will pay approximately 60% of the Federal portion of the allowed amount. If $ is allowed for one unit, Medicaid will pay approx.

$ • The District is responsible for the remaining 40% State portion. • Direct Services reimbursement should go back into the Direct Services Size: KB. The Medicaid School Program: An Effective Public School and Private Sector Partnership What is clear is that many mandates are involved when Medicaid services are delivered—federal regulations, Questionable practices boost federal payments for school-based services Author: Christopher A.

Mallett. applicable to all Medicaid participating providers. According to federal investigations and congressional hearings, Medicaid payments to schools have sometimes been improper. The President’s FY budget proposal would prohibit federal Medicaid reimbursement for IDEA-relate d school-based administrati on and transportation by: 1.

2 See Medicaid Questionable Practices Boost Federal Payments for School-Based Services. Testimony by William J. Scanlon before the Senate Finance Committee on J (GAOIT-HEHS), and Medicaid in Schools. states claim Medicaid reimbursement for school-based health services and Questionable Practices Boost Federal Payments for School-BasedServices (GAO/T-HEHS, J ).

Page 3 5. reimbursement for school-based services do notensure that health services.school-based Medicaid services and activities, the potential benefits to schools and children are being compromised by poor guidance and oversight from the Health Care Financing Administration (HCFA) and improper payments that divert public funding from its intended purpose.

The methods used by.A quarterly Medicaid administrative claim must be prepared and submitted to AHCA. Further, monitoring of administrative claiming records is required by AHCA and the federal Centers for Medicare and Medicaid Services (CMS).

SDAC payments are from federal funds and school districts must make such SDAC records available for periodic AHCA and CMSFile Size: KB.