RS22397
Medicaid and Schools
December 20, 2007
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Summary
As a condition of accepting funds under the Individuals with Disabilities Education Act (IDEA), public schools must provide special education and related services necessary for children with disabilities to benefit from a public education. Generally, states can finance only a portion of these costs with federal IDEA funds. Medicaid, the federal-state program that finances medical and health services for the poor, can cover IDEA required health-related services for enrolled children as well as related administrative activities (e.g., outreach for Medicaid enrollment purposes, medical care coordination). Despite written federal guidance, schools have difficulty meeting the complex reimbursement rules under Medicaid. According to federal investigations and congressional hearings, Medicaid payments to schools have sometimes been improper. During 2007, Congress passed two bills to continue funding of the State Children's Health Insurance Program (SCHIP). H.R. 976 and H.R. 3963 included a moratorium on the issuance of new federal regulations restricting Medicaid coverage or payments for school-based services; both bills were vetoed by the President. In September 2007, the Bush Administration issued such a proposed rule. In mid-December, Congress passed the Medicare, Medicaid and SCHIP Extension Act of 2007 (S. 2499), which included a moratorium on the issuance of such a regulation until June 30, 2008. Under IDEA, public schools are required to provide children with disabilities with a free appropriate public education (FAPE), including special education and related services according to each child's individualized education plan (IEP) or individualized family service plan (IFSP). States receive some federal aid under IDEA, but are otherwise responsible for the expense of special education and related services. One approach Congress has taken to ease the burden on states and school districts of fulfilling these IDEA requirements is to allow Medicaid to finance covered health services (e.g., physical, occupational and speech therapy, and diagnostic, preventive and rehabilitation services) delivered to low-income, Medicaid-eligible special education students.
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Related Legislation:
- H.R.976
- H.R.3963
- S.2499
