Client Notice on March 18, 2013 Billing Delay

As you all probably now know on Thursday, February 14, 2013 the United States Department of Education issued new regulations controlling how local education agencies (LEA) can secure consent from parents to bill Medicaid. This is the first time the specifics of the process to be used in securing consent has been placed in the federal regulations. More information can be found at http://www.kinneyassoc.com/new_2013_federal_consent_regulat.htm.

This release contains the following requirements:

1. A written notification must be provided to parents, guardians or students (if 18 or older) explaining all of the protections available to them under Part B, as described in 34 CFR §300.154(d)(2)(v) to ensure they are fully informed of their rights. This must be done prior to the LEA accessing their or their child’s public benefits or insurance to pay for services under the IDEA.

2. From March 18, 2013 on billing cannot be submitted until parents, guardians or students (if 18 or older) are given the newly mandated notice.

3. Once the notice has been provided existing consents can continue to be used as long as there has been no change in the type or amount of services being provided and no change in the amount being charged to (paid) by Medicaid. Any change in the IEP or in the Medicaid payment amounts requires the new one time consent be secured.

4. Informed signed consent must be secured by the LEA that is going to bill. The LEA can no longer use consent secured by another agency (e.g. the Medicaid application) nor a consent secured by another LEA.

5. The regulation goes into effect on March 18, 2013.

The regulation makes it a requirement that the mandated notification of rights be provided prior to the securing of a person’s consent and prior to continuing billing for those who have already given consent. As a result an LEA must provide the mandated notification before any billings are submitted from March 18, 2013 on. Ksystems is being changed to allow for the recording of the notice information. This information will be used to release billings.

NOTE: NO BILLING WILL BE RELEASED FROM MARCH 18, 2013 ON UNTIL THE NOTIFICATION INFORMATION HAS BEEN ADDED TO KSYSTEMS.  

Also, in all states using a Medicaid cost settlement process the Medicaid payment amounts change each school year. Therefore, for the 13-14 school year the LEA needs to notify all parents, guardians or students (if 18 or older)  of their rights and then secure the newly mandated one time signed consent for all Medicaid eligible children.

One last note. This new regulatory requirement must be adhered to as submitting Medicaid claims without a properly secured consent could lead to a federal false claims action against the LEA.

We are in contact with the State and are told they are working on a new release that will provide implementation instructions. .