Current through Register Vol. 50, No. 9, March 1, 2024
RELATES TO:
KRS
156.070,
605.115
NECESSITY, FUNCTION, AND CONFORMITY:
KRS
156.070 sets forth the Kentucky Board of
Education's plenary powers over the management and control of local school
districts and, along with
KRS
156.160, gives the Kentucky Board of
Education the authority to promulgate administrative regulations deemed
necessary for the management of the school districts under its control. This
administrative regulation is necessary to provide guidance for local school
districts that choose to be Medicaid providers.
Section 1. Definitions.
(1) "School district Medicaid recipient"
means one who has been determined eligible for Medicaid-covered benefits
provided by a local school district participating in the Medicaid
Program.
(2) "School district
Medicaid provider" means a local school district which has entered into an
agreement with the Department for Medicaid Services, Cabinet for Human
Resources, to receive Medicaid reimbursement for health-related services
provided by the district.
Section
2. School District Medicaid Provider Agreements.
(1) Pursuant to
KRS
605.115, the Department of Education shall
enter into an agreement with the Department for Medicaid Services, Cabinet for
Human Resources, to provide reimbursement upon request to local districts for
Medicaid covered benefits provided to eligible students.
(2) Local school districts may enter into an
agreement with the Department for Medicaid Services, Cabinet for Human
Resources, to become eligible to receive Medicaid reimbursement for Medicaid
covered services provided to eligible students pursuant to
KRS
605.115.
(3) Local school districts which choose to
participate shall be required to comply with provider participation criteria
set forth in
907 KAR
1:715, 907 KAR 1:034, and 907 KAR 1:035, promulgated
by the Department for Medicaid Services, Cabinet for Human Resources.
Section 3. Administrative
Guidelines.
(1) To receive federal Medicaid
reimbursement, local school districts shall provide the state's share of the
Medicaid expenditure and shall be required to document and certify the
expenditure of state funds for Medicaid reimbursable services provided to
Med-icaid eligible student recipients. This certification of the availability
and expenditure of state funds shall be provided as needed to the Department
for Medicaid Services by local school districts for verification of state
matching funds entitling the local school district to reimbursement for
specific Medicaid reimbursable services provided by the school district.
Certification shall include a statement on the Medicaid claim form or a signed
statement from the local school district superintendent or finance officer. The
Department of Education and the Department for Medicaid Services, Cabinet for
Human Resources, may examine any records, files, or documents necessary to
verify expenditures for Medicaid covered services for which certification of
state matching funds has been made.
(2) Documentation of available or expended
state matching dollars shall be provided as required by the Department for
Medicaid Services and may include the following:
(a) Records relating to time and attendance
of service providers; or
(b)
Records of expenditures, including invoices, related to the services provided
by or through the local school district.
(3) Federal funds shall not be used by school
districts to match Medicaid funds.
(4) Local school districts shall include in
the annual audit an accounting of revenues and expenditures relative to serving
Medicaid eligible student recipients. The Department of Education shall provide
the Cabinet for Human Resources a copy of this annual audit.
(5) The Department for Medicaid Services,
Cabinet for Human Resources, the Health Care Financing Administration of Health
and Human Services, the Office of Inspector or their designated representatives
may audit a local school district to verify compliance with all federal and
state Medi-caid statutes and administrative regulations relating to local
school district receipt of Medicaid reimbursement for approved
services.
Section 4.
Parent/Guardian Consent.
(1) Local school
districts shall obtain written parent or guardian consent pursuant to the
requirements of the Individuals with Disabilities Education Act (IDEA)
Regulations (34 CFR 300) prior to provision of services in an individual
education program (IEP).
(2)
(a) Parents or guardians shall be given prior
written notification on an annual basis that the local school district may be
submitting claims for Medicaid reimbursement of health related services
provided to students with educational disabilities as required by the student's
IEP.
(b) The rights of the parent
or guardian under IDEA shall not be affected in any way as a result of the
local school district's participation in the Medicaid Program.
STATUTORY AUTHORITY:
KRS
156.070,
156.160