Special Education Listserv

Subject: Medicaid/Payment for School District Administration Program

(SDAC) and Non-Emergency Medical Transportation (NEMT)

Source: Shelley Witherbee, Supervisor, Funds Management

Intended Audience: School Administrators, Directors of Special Education, Medicaid Billers

Date: January 3, 2008

The Centers for Medicare and Medicaid Services (CMS) new rule (CMS-2287-F) cutting Medicaid reimbursement to school districts for school district administration claiming (SDAC) and non-emergency medical transportation (NEMT) was scheduled to go into affect in sixty days; however, the new SCHIP bill (S.B. 249) established a six month moratorium.  Districts may continue to claim Medicaid reimbursements for administrative services up until June 30, 2008.  Additional information will be forthcoming about the phase-out process.  The final rule may be viewed at:  http://www.cms.hhs.gov/MedicaidGenInfo/Downloads/CMS2287F.pdf. 

The final rule does not affect reimbursement for direct therapy services (Occupational, Speech, and Physical Therapy).  Districts may continue to direct bill for these services.  Districts who are not currently direct billing may want to consider the possibility to help offset the loss of SDAC reimbursements.

Questions regarding the final rule may be directed to Shelley Witherbee at (573) 522-2523 or shelley.witherbee@dese.mo.gov.  You may also contact Maximus, the state contractor for SDAC services, at (573) 673-2013 or collinswearingen@maximus.com.