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Strategizing Medicaid

It's safe to say that school organizations are still stung by a federal decision made in December to stop reimbursing schools for some of the services schools provide to students with disabilities. (See my last story on this topic here.)

When schools offer programs like speech or occupational therapy to low-income students, Medicaid pays them back. However, the Centers for Medicaid and Medicare Services, the government agency responsible for administering Medicaid, decided to cut out reimbursements for getting those kids to school. School is primarily an educational setting, the agency said. The government also won't pay school personnel for the administrative costs of managing its Medicaid programs. School districts say they have to bear these costs no matter what, so cutting out the reimbursements takes a big chunk out of their budgets.

The CMS made these changes by publishing new rules. In late December, Congress stepped in to give schools some breathing room by passing a bill preventing the rules from going into effect until July.

Now, for the strategizing. I met earlier today with representatives from a coalition of education groups, including the National Association for State Directors of Special Education, the American Association of School Administrators, and National Conference of State Legislatures.

Bruce Hunter, a public policy chief with the AASA, said a lawsuit isn't off the table if interested groups are able to find the money, along with a brave enough plaintiff. But the education groups are also reaching out to non-education groups that are mad about other changes made to Medicaid rules. What these groups all share is a feeling that their objections were dismissed during the public comment period on the changes, said David Shreve, an education policy official with NCSL.

"Any input was ignored," Shreve told me. "The common denominator for us is that the process was perverted."

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