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You are here: Home / Resources / News / Massachusetts News / Why is October 5th important? (MA)

October 3, 2016,

Why is October 5th important? (MA)

Why is October 5th such an important date in the MA School-Based Medicaid calendar? 

Along with July 5th, January 5th and April 5th, school districts who participate in the School-Based Medicaid program must determine the Medicaid eligibility of both their entire student body as well as their special education students.  The state requires these 4 times per year to determine who is actually enrolled in the districts on these dates.

CalendarAs of each date, districts should use their student information systems (i.e. PowerSchool, Infinite Campus, eSped, Adori, etc.) to run both lists and include the first name, last name, date of birth and gender.  Districts then directly, or with the assistance of their Medicaid vendor (UMass, MSB, etc.) compare these lists electronically with the Health and Human Services electronic database of eligible members to determine their district’s percentages of Medicaid eligibility.

This is very important to do because:

  • It’s required of all districts who participate in the Medicaid program
  • These figure provide statistics that are used to determine rates of reimbursement to participating school districts, and have a significant impact as to how much Medicaid reimbursement a district receives

If a district were to be audited by either MA Executive Office of Health and Human Services or by the federal Centers for Medicare and Medicaid Services, it is probable that the district would be asked to produce the lists they run each 5th of the quarter, and demonstrate their process for matching eligibility with the state database.  The Provider Contract between the districts and MA Health and Human Services requires districts to maintain these records for at least six years for purposes of audit.

Should you have questions or would like more in depth information about this topic or School-Based Medicaid in general, please do not hesitate to give us a call, 800-618-3111.

Section 504 Management

Managing Section 504

How can you be sure you are effectively managing your district’s 504 data and documentation?

The duties of school districts under The Americans with Disabilities Act (ADA) continue to expand and the documentation requirements for those students who are eligible for Section 504 are no exception. 

School-based Medicaid

EDMS’s School Medicaid Administration System empowers administrators to effectively manage their responsibility to submit compliant claims for Special Education students who are enrolled with Medicaid.

Special Education Management

Adori™ is our web-based integrated IEP software and special education management system. With a focus on compliance and efficiency, it is a total special education management process at your fingertips.

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