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New Regulations on Medicaid Payments for IDEA Services


Parents: Is your child eligible for Medicaid (government-provided health insurance for low-income individuals)? If so, we want to make sure you know about new regulations regarding parental consent for the use of public benefits or insurance to pay for services your child may receive under Part B of the Individuals with Disabilities Education Act (IDEA). These regulations will take effect on March 18, 2013. It is important you understand what these new regulations could mean for you and your family.

In the past, regulations required your child’s school to obtain your consent each time access to public benefits or insurance (Medicaid) was sought to pay for eligible services your child receives in school under IDEA.

The new regulations begin on March 18, 2013 and require that:

  1. Your child’s school must notify you in writing (by postal mail, e-mail, and/or at the IEP meeting depending on the state) if your child’s school will be using public benefits or insurance to pay for your child’s IDEA-required in-school services.
  2. The school must obtain a one-time written consent (electronic format accepted) from you stating that you understand and agree that the school may access your family’s public benefits or insurance to pay for special education or related services under IDEA.

Note: If there is a change in the type amount, or cost of services provided to your child that will be charged to your public benefits or insurance program, you will be notified and asked for written consent again.

What Do The New Regulations Mean For My Family? The new regulations issued by the Department of Education substantially reduce your parental consent requirements when your school district seeks to use public benefits or insurance to pay for your child’s education services.

Benefits the new regulations provide:

  • Your child may be more likely to receive the services he or she needs because schools are able to pay for services through your family’s public benefits or insurance with minimal delay.
  • You continue to have the right under IDEA to revoke your consent for the services at any time. 
  • If you do not grant consent to Medicaid eligible services, your school must still provide your child a free and appropriate public education.

Challenges the new regulations may pose:

  • Because you do not grant specific consent each and every time the school accesses your public benefits, you may not be as aware of what benefits your child is receiving and who is paying for them.
  • Schools may improperly bill public insurance and you will have fewer opportunities to be made aware of this.
  • Allowing a school district unlimited access to Medicaid benefits could prevent your family access to other needed services through Medicaid that the school does not otherwise provide.

So Now What? You deserve to play a meaningful role in your child’s life, and that includes making informed and meaningful decisions regarding your child’s education and medical insurance benefits. Stay informed! Know what services the school is providing for your child.

If you use Medicaid for out-of-school services for your child now, find out from your provider if these out-of-school services will be denied if the school uses Medicaid to provide in-school services. Most importantly, know your rights!

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