Legislative Platform
Q. What contractual agreements are required to initiate our school district’s participation in MSBA’s Medicaid Consortium?
A. Your Board of Education will have to approve the school district entering into a "Cooperative Agreement" with the Department of Social Services' MO HealthNet Division, and a "Memorandum-of-Agreement" with MSBA. Should you choose to join MSBA Medicaid Consortium, these documents will be provided and explained to you by a member of our staff.
Q. How will my staff receive training on the process of Medicaid claiming?
A. SDAC Coordinators are required by Mo HealthNet Division (MHD) to participate in a minimum of one training annually. MSBA Medicaid Consortium provides quarterly training sessions at regional sites across the state to help districts meet this requirement. In addition, all participants on the Personnel Roster are required to be training annually. Historically, this has been done using a train-the-trainer model with the SDAC Coordinator providing training for district-level staff. To assist districts with this responsibility, MSBA Medicaid Consortium has produced a DVD titled: "MO HealthNet School-Based Administrative Claiming: Random Moment Sample Training." This will be provided to each district in the Consortium on a DVD for use during group training or participants may access the training on-line.
Training for direct service claiming and transportation billing is provided on a district-by-district basis, with customized training by MSBA Medicaid Consortium staff offered in the district or on-line.
Q. What is the connection between MSBA and Medicaid claiming?
A. Each State has a School Boards’ Association, a number of those states, the School Boards’ Association acts as the Third Party Billing Agent on behalf of its member school districts. This is a logical connection because of the active role that the local Board of Education must play in concert with school district administrators and the community with respect to those activities that are allowable and billable under the Medicaid program.
According to Missouri’s "State Plan" for Medicaid claiming, "Participation in administrative claiming involves a contractual relationship between the Missouri Department of Social Services, MOHealthnet Division and a school district. This contract binds the Department of Social Services and a school district’s Board of Education in a relationship whereby the Department is obligated to reimburse the school district when it performs certain claimable activities."
Q. Does a school district’s Board of Education play a role in Medicaid claiming?
A. Yes. The Board of Education must approve a contractual agreement with the Department of Social Services and a separate contractual agreement with a Third Party Billing Agent if the school district chooses to use one. As a result, there are significant legal and fiduciary responsibilities that the Board must address with respect to Medicaid claiming.
In addition, there is an important role the School Board plays in relationship to Medicaid activities within a school district as is explained in Missouri’s "State Plan" for Medicaid Claiming. In this regard, Section 5.1, Step #1—DISTRICT COMMITMENT TO MISSOURI’S MEDICAID HEALTH CARE AGENDA, reads as follows: "…to effectively implement the program in a district at least two primary supports exist: (a) the board of education endorses and actively promotes the effort within the community; and (b) the administration provides the leadership and supports required. With these supports in place, the district’s activities and the goals of the program will be compatible."
Q. What are the financial implications for school districts that choose to join MSBA's Medicaid Consortium?
A. For those joining MSBA's Medicaid Consortium at this time, the MSBA’s Medicaid Consortium will charge the following. For SDAC services to MSBA member districts a contingency fee of 5.25% for any SDAC funds that are generated. Non-MSBA member districts will be charged a contingency fee of 5.5%. Direct Service and Transportation Billing is provided to MSBA member districts at a contingency fee of 10% for any funds that are generated. Non-MSBA member districts will be charged a contingency fee of 11%.