School Medicaid Consulting

With more than 21 years assisting public schools with School Medicaid, EDMS is able to provide your district with professional, dependable support for your School Medicaid programs.

EDMS has experience in the following types of School Medicaid programs:

1. Fee-for-Service
2. Cost-based with End of Year Cost Reporting
3. Administrative Activity Claiming (AAC) / Medicaid Activity Claiming (MAC) / Medicaid Administrative Activity (MAA)
4. Random Moment Time Study (RMTS)
5. Level of Care (LOC)
6. Direct Services Claiming (DSC)

While we provide Medicaid claiming services for public schools, we can also offer our consulting services with or without actually processing claims on behalf of the school district.

Our expertise with school Medicaid includes:

• Development of tools and resources that assist public school districts with compliance, quality review, and documentation that addresses program requirements
• Assistance with School Medicaid audits – if you’re contemplating an audit or are currently being audited, EDMS may be able to help.
  1. In advance of an audit engagement, we provide information that can help districts become better prepared to answer questions, provide documentation that meets program requirements and respond effectively to audit requests.
  2. If you are currently undergoing an audit, EDMS can work with you to avoid unnecessary costly mistakes and omissions that lead to audit recoupments. There will almost always be audit findings and many of those include duties for districts to pay back Medicaid funds.  This is a critical juncture in audits and often we can help mitigate the extent of Medicaid recoupments.
• Professional development with district administrators and Medicaid participants – with the ever-changing landscape surrounding School Medicaid programs, it is often very difficult for district personnel to keep up with regulations, rules and guidance that accompany your School Medicaid reimbursement programs. EDMS can help you and your colleagues become more aware of program requirements and suggest ways that you can remain current.  With the ability to understand the complex nature of School Medicaid programs, we can compile comprehensive checklists and work with your teams to help them understand the requirements.  Our tools can help prepare them to develop action plans that can ensure you have effective compliance monitoring and quality review in place.
• School Medicaid policy and program support – EDMS can partner with school districts and other stakeholders in your state in order to:
  1. Review School Medicaid programs’ compliance with federal and state requirements
  2. Highlight opportunities for additional Medicaid funds for school districts
  3. Examine where School Medicaid requirements are unnecessarily burdensome for public schools and advocate for improvements
  4. Work with existing state associations to provide expertise as they advocate for their members (i.e. Superintendent’s Associations, Special Education Administrator Associations, etc.)
  5. Become a liaison on behalf of your school district with state Medicaid agencies to seek clarification on program requirements and document responses for future reference

If you would like to get started with a free consultation to assess your School Medicaid needs, call or email today and we will be in contact with you to discuss how we can best help.