School-Based Medicaid

Medicaid can be an important revenue source for schools providing high quality services to students with disabilities.

As public agencies, LEAs are entitled to seek Medicaid reimbursement for school-based health services provided to eligible students with Individualized Education Programs (IEPs). The Co-op has been assisting charter schools with Medicaid reimbursement since 2006 and has extensive experience working with the Department of Health Care Finance (DHCF) and other city agencies. The Co-op is the expert when it comes to DC charter schools and Medicaid billing. When LEAs opt-in to our Medicaid Billing program, they receive exceptional customer service and support throughout the billing process and recommendations for improving overall special education compliance and service delivery.

Framework alignment

  • Special Education Infrastructure

Why Medicaid?

Accessing Medicaid funding for school-based health services has been a challenge for charter districts. Medicaid for school based health care is complex, and even our larger charter districts lack the internal capacity to navigate the regulations and technical aspects of claiming. As a cooperative, we’re able to pool our resources and share the costs of creating a “central office” for our Medicaid claiming.

MEDICAID BILLING Program activities:

  • DC Medicaid Provider application guidance and support
  • Billing set-up and ongoing claim submission
  • Ongoing training and troubleshooting
  • Reporting and technical assistance
  • Audit preparation and support

Program evaluation and impact:

We are constantly refining our program to better meet the needs of our LEA partners. Since launching our expanded billing services in 2014, we have helped the charter sector recoup over $6M, leading to more local dollars for much needed resources. Our client retention rate in SY17-18 was 100%.