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JLCG, Medicaid Reimbursement

JLCG, Medicaid Reimbursement

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In all cases in which a student is enrolled in the Colorado Medicaid program, the district shall seek reimbursement for health-related services rendered by qualified district staff. District staff shall make a reasonable effort to coordinate care with the student’s health care provider to avoid duplication of services.

As a Medicaid provider, the district shall access Medicaid eligibility information for students from Health Care Policy and Financing (HCPF). HCPF is the designated Medicaid agency for the state of Colorado.

Directory information, including names, dates of birth and gender will be released to HCPF to verify Medicaid eligibility of students. The description of health services delivered and information needed to complete claims shall be released to Medicaid and/or the district-billing agent for proper administration of the program.

The district shall obtain written consent annually from parents/guardians before the release of any non-directory information required for billing. To accomplish this, the district shall include a consent form in its “start of school” information each fall and in its packet of IEP materials.

All ongoing health and related services shall be rendered by qualified district staff pursuant to an individual health service plan signed by a professional qualified to provide the types of services described in the plan. The plan may be an Individual Education Plan (IEP), Individual Family Services Plan (IFSP), Section 504 Accommodation Plan or any individual health services plan.

A dated record of all transactions shall be kept on file at the school office.

Adopted March 1, 2000
Revised June 2001

Legal References

CRS 24-72-204 (3)(e)(I)
CRS 26-4-531
Public Law 100-360, July 1, 1988

Cross Reference

JRA/JRC, Student Records, and sub codes