Transcript SEMI Special Education Medicaid Initiative

SPECIAL EDUCATION
MEDICAID INITIATIVE (SEMI)
PRESENTED 3/5/14 M.FENWICK
SEMI: OVERVIEW
Special Education Medicaid Initiative (SEMI) is a
school-based federal program that allows the district
to bill Medicaid for services that are provided to
eligible students.
http://www.state.nj.us/treasury/administration/semi-mac/semi-mac.shtml
SEMI: A SCHOOL-BASED INITIATIVE
This program is of no cost to parents and does not
impact a family's Medicaid services, funds or
coverage limits in any way.
It is a school-based service initiative.
WHY DO WE PARTICIPATE?
• We are required.
• Any district over a given number of eligible students are
required to participate.
• Failure to participate can result in loss of funding to districts.
• It helps bring revenue to the district.
• When a student with disabilities who qualifies receives
eligible services, a portion of those services can be billed
which brings money to the district.
PARENT CONSENT
We participate by first getting Parent Consent and
then keeping track and submitting eligible services for
reimbursement.
There must be one parent consent on file for up to
seven years after a student has withdrawn from the
district.
SAMPLE PARENT CONSENT FORM
SCHOOL-BASE SERVICES PROGRAM
ACTIVITIES COVERED
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Evaluations
Speech Therapy
Occupational Therapy
Physical Therapy
One IEP Meeting/yr
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Psychological Counseling
Audiology
Nursing
Specialized Transportation
WHAT INFORMATION IS SHARED
• SEMI Reimbursement
In order to submit claims, records may be required
that include:
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First, Middle, & Last Name
Address
Date of Birth
Student ID
Medicaid ID
Disability
Service Dates
Types of Services Delivered
WHO WILL SEE THIS INFORMATION?
Information about your child’s special education
program may be shared with NJ Division of Medicaid
Assistance & Health Services, Department of the
Treasury, PCG, & NJ Department of Education in
order to verify the school-based claims for services.
PARENT CONSENT
If you give a Yes consent:
If you give a No Consent:
• Your child receives IEP
services
• The district is able to bill
Medicaid for eligible
services
• No changes occur to
your status
• Your child receives IEP
services
• The district cannot bill
Medicaid for eligible
services
• No changes occur to your
status
You can withdraw at any time by contacting the district.
QUESTIONS?
• SEMI NJ WEBSITE
http://www.state.nj.us/treasury/administration/semi-mac/semi-mac.shtml
• Our PLPS District website
http://www.plps-k12.org/Page/2657
• Call or Email
Michelle Fenwick
973 835-4722 [email protected]
Barbara Fontanazza, SEMI Coordinator
[email protected]
Thank you