KFF Brief Examines Medicaid Reimbursement for School-Based Services Under IDEA
A KFF brief analyzes how Medicaid finances health and related services delivered in school settings for students with disabilities. Federal law allows state Medicaid programs to reimburse schools for covered services provided to Medicaid-enrolled children when medically necessary and included in an Individualized Education Plan (IEP). The brief addresses the intersection of Medicaid payment policy and Individuals with Disabilities Education Act (IDEA) requirements. This affects state Medicaid agencies' payment methodologies for school-based services and managed care organizations' responsibilities when schools are in-network providers.
State Medicaid agencies must ensure payment policies comply with federal requirements for school-based services while managed care contracts must address how MCOs reimburse school districts for IEP-related health services.
Managed Care · Finance
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