On February 25th, Jeff McCuen, the treasurer for Worthington City Schools did a very good presentation on several important issues related to the Ohio Medicaid School Program (MSP). He presented to a large diverse audience made up of school districts, state legislators, educational associations, billing vendors, therapy associations, and representatives from the Ohio Department of Education and the Ohio Department of Medicaid. There were also over 80 viewers watching online. The four main issues covered were:
- Board Member Social Security number requirement for MSP re-enrollment.
- Extension of time beyond 08/01/16 to resolve “Order, Refer, Prescribe” (ORP) requirement.
- Removal of SLP’s, OT’s, and PT’s ability to be “Practitioners of the Healing Arts”, and ORP IEP services.
- Discontinuance of the monthly “MSP Stakeholder” meetings that had made great progress on resolving many MSP issues.
Nothing was resolved in the 2/25 meeting, but it did bring these issues to the attention of State Legislators, the State School Board President, and many other interested parties. The strong presence of school district representatives spoke loudly to the importance that the Medicaid School Program enhance the services that are provided to students with disabilities, but not hinder those services in the process. We have several important meetings scheduled in the coming weeks, but the most important issue is to get ODM to agree to an extension beyond the August 1 deadline. Many districts are ready to move forward with the prescription requirement, but we need to get many questions answered so that systems can be developed to meet the proposed requirement, or whatever the final requirements may be.
The ORP issue relates directly to another topic that I have been wanting to write about. Buried deep in the MSP rules is a requirement that districts have received very little guidance from ODE/ODM on, but could be a good first step in preparing for the proposed ORP requirement.
OAC 5160-35-06 (MSP Rules) states that:
(E) “The documentation for provision of each service shall be maintained for purposes of an audit trail. Documentation shall include:”
(7) “A description of efforts made to coordinate services with the eligible child’s medical home in accordance with the medicaid provider agreement.”
In this rule, “medical home” means “primary care physician”.
Care Coordination is an important component of all medical delivery systems. MSP Nursing Services already do care coordination, as their services already require a physician prescription. Many districts actively coordinate IEP services with the student’s primary care physician, but some do not. Most districts request the primary care physician information upon enrollment, but many do not keep this information current. I am gathering form examples from various districts, and I will be putting together a suggested process for meeting the care coordination requirement of the Ohio Medicaid School Program. Please share any examples that you have successfully used in your school district.
While we are waiting for ODE/ODM to answer questions, grant an extension, and hold stakeholder meetings, I do encourage districts to start looking at their internal systems and how they currently coordinate care for IEP services. Determine what physician information you already have for IEP students, and whether or not the information is current. In the coming weeks, I will be sharing with each district an all-inclusive form/system that would meet the current care coordination requirement and could easily adapt to meet a future physician prescription requirement.
I have not given up on the hopes of going back to allowing the therapists to ORP their services, but we must be proactive and address the care coordination requirement and be ready for any ORP requirement change.
Once again, I would like to thank Jeff McCuen from Worthington City Schools for bringing everyone together to discuss these important issues. Thanks also for all those who attended, watched online, and those who have sent letters and emails to ODE and ODM.