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Special Education Listserv

Subject: School District Administrative Claiming (SDAC) Changes

Source: Shelley Witherbee, Director, Funds Management

Intended Audience: SDAC Coordinators, Special Education Directors, Superintendents, Financial Administrators

Date: July 14, 2008

On June 30, 2008, the President signed the War Supplemental Bill which included a moratorium that will allow for federal Medicaid reimbursement for School District Administrative Claiming (SDAC) and Non-emergency Medical Transportation (NEMT) services to continue until at least April 1, 2009.

The current contract between the state Department of Social Services

(DSS) and Maximus, the state contractor for SDAC services, expired on June 30, 2008.  DSS will not be renewing the contract nor will they have a new contractor to handle the SDAC components.  Effective July 1, 2008, each individual school district will be allowed to administer the SDAC program for their own district or seek an outside vendor to perform the functions of the SDAC program on their behalf. These functions of the school district and/or vendor include:

* Sign an interagency agreement with the Department of Social Services.

* Provide and maintain a Random Moment Sampling process for your district to determine the percentage of staff time providing School District Administrative Claiming reimbursable activities.

* Provide and maintain a personnel roster for your district that is updated prior to the start of each calendar quarter.

* Provide and maintain a student data file for your district that is updated annually.

* Provide and maintain a cost data pool file for your district of all eligible employees' salaries and benefits that is updated on a quarterly basis.

* Provide and maintain a provider participation rate (PPR) file for your district that is updated on a quarterly basis.  The provider participation rate file is a data file of all providers (MO HealthNet and non-MO HealthNet) that the district referred students to for any and all medical services and is matched to the MO HealthNet enrolled provider file.

* Provide a quarterly claim for your district to the Department of Social Services, MO HealthNet Division (MHD), in the manner outlined in the "School District Administrative Claiming Guide" located at http://manuals.momed.com.  

There is a Cooperative Agreement between the Department of Social Services (DSS), MO HealthNet Division (MHD), and your school district for the provision of the School District Administrative Claiming (SDAC) program.  This agreement is being amended effective July 1, 2008, and will be sent to districts with a letter outlining the reason for the amendment and the changes occurring within the program.  This agreement must be signed and returned to DSS in order to continue to participate in the SDAC program by August 31, 2008.

For SDAC services provided prior to June 30, 2008, you are to continue reporting all staff, student, wage, and benefit data to the prior state contractor, Maximus.  Maximus will generate invoices to the State for SDAC activities provided by school districts through June 30, 2008, to be processed and payments made to school districts.

As mentioned above, after June 30, 2008, districts may choose to administer the SDAC program themselves or contract with a vendor of their choice to perform the functions associated with claiming.  The district needs to ensure that their vendor is following the approved SDAC Provider Manual guidelines.  The 2008 SDAC guidelines may be found

at: http://manuals.momed.com.