An Overview of the Medicaid Program
School Based Health Services
The Social Security Act, amended by the Medicare Catastrophic Coverage Act of 1988, provides for Medicaid reimbursement for health-related services for a special education student included in an Individualized Education Program (IEP) or in an Individualized Family Service Plan (IFSP) for an infant or toddler with a disability.
In 1993, the Michigan Medical Services Administration (MSA), the Michigan Department of Social Services (now the Family Independence Agency or FIA), and the Michigan Department of Education entered into an agreement which allows Michigan public schools to be reimbursed for specific medical services provided to special education students who are Medicaid eligible. Examples of reimbursable medical services include, but are not limited to,
- Speech, occupational, or physical therapy;
- Vision services;
- Orientation and mobility services;
- Psychological counseling and social work services;
- Developmental testing;
- Nursing; and
- Individuals with Disabilities Education Act (IDEA) assessments.
Commonly referred to as School Based Services (SBS), the program was instituted by all 12 public school districts in Muskegon County under the auspices of the Muskegon Area Intermediate School District. (MAISD). The MAISD acts as the enrolled Medicaid provider but the reimbursements are distributed to the local school district which provided the service (less administrative costs).
Information related to a student’s Medicaid enrollment and the services rendered on behalf of that student are private and confidential and cannot be released to anyone other than the person providing the service and for administrative functions, including Medicaid billing.
On November 1, 1996, Phase II of the School Based Health Services was passed by the Health Care Financing Administration (HCFA), which approves the State Plan services for Michigan Medicaid coverage. Phase II included the option for public schools to bill for case management. Up until this point, case management had only been billed by agencies such as Community Mental Health.
On October 1, 2003, the School Based Health Services program was updated and is now known as Fee for Service program.
Forms, instructions, and other material contained on this website are to be used only by authorized personnel or contractors of public schools for the purpose of Medicaid claim reimbursement. Any other use, without the expressed written permission of the Muskegon Area Intermediate School District, is prohibited.