Medicaid - Mission Statement
"The SWREC is maximizing Medicaid reimbursement for services school districts provide to eligible students and to assist these districts with regulatory compliance with the Individuals with Disabilities Education Act (IDEA)."
History / Overview
SWREC has been working with school districts that provide school based health services and has experience in billing both Medicaid fee for service (FFS) and administrative claims. We believe our staff must be geographically accessible and provide close personal support to each district we serve. Thus, our staff is in close proximity to our client school districts so that we can be easily accessible to provide personalized training and ongoing support to clinicians, school employees, administrators and the individuals who actually provide school based health services.
The Medicare Catastrophic Coverage Act of 1988 (MCCA) and the Omnibus Budget Reconciliation Act of 1989 (OBRA '89) gave state Medicaid programs the authority through the Early and Periodic Screening, Diagnosis and Treatment (EPSDT) initiative to reimburse schools for the expenses of health related services including screening activities and related service provided to Medicaid eligible children as part of an Individual Education Program (IEP) or an Individual Family Service Plan (IFSP). This program does not affect the Medicaid status of families in any manner.
New Mexico schools provide a variety of health-related services to students. IDEA and Section 504 require schools to accommodate students who have a disability and who are in need of services. The expense of these services is managed by the school districts through a combination of federal, state and local funds.
Southwest Regional Education Center coordinates the use of Medicaid reimbursement funds to improve health related services for all students in our five participating school districts, which include Animas, Hatch, Lordsburg, Reserve and T or C.
Schools receive Medicaid reimbursement for providing a broad range of preventative and remedial health care services as described in a plan adopted by the State Human Services Department for the state of New Mexico. A plan to address regional health care issues was developed by an advisory group of local health care providers, parents and school personnel.
Services / Activities
Some of the services/activities funded by Medicaid School-Based Services include:
· School social workers · Case Management · Occupational Therapy · Physical Therapy · Speech Language Therapy · Personnel development and training activities for healthcare providers · Health-related equipment and materials · Mental health/Psychologist
Federal Medicaid reimbursements provide the funding for the health related services described above.
The New Mexico Department Of Health is a state government agency that strives to promote health and sound health policy, prevent disease and disability, improve health services systems and assure that essential public health functions and safety net services are available to New Mexicans. Southwest Regional Education Center offers technical assistance and various additional resources to member and participating districts to help insure that all students receive a free, appropriate education. Additional information regarding Medicaid reimbersement can be accessed from the Medicaid Links page.
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Supporting Member Districts in Southern New Mexico