Thread: ILLEGALS LOSE A LITTLE MORE????

SCHOOLS HAVE NO BUSINESS BEING INVOLVED IN THIS. THAT'S THE JOB OF PARENTS.

Area Schools Set To Lose Millions Under Medicaid Policy Changes

By Maria Glod
Washington Post Staff Writer
Sunday, February 3, 2008; Page A01

Educators nationwide are protesting a Bush administration move to curtail hundreds of millions of dollars in Medicaid funding for disabled students that could force some schools already in budget straits to trim health services or cut back instructional programs.

The shift in federal reimbursement policy threatens to strip about $635 million from schools in the next academic year and $3.6 billion over five years, with Washington area schools in line to lose millions of dollars. The rule, to take effect in June unless Congress intervenes, will bar schools from billing Medicaid for busing special education students to and from school and for certain administrative expenses, including enrolling children in Medicaid and coordinating and scheduling services.

Administration officials said schools, required under federal law to provide education to children with special needs, should pick up the bill for expenses that are part of their "educational mission." But educators said it would further strain schools in a time of lean budgets, hitting big city and poor rural systems hardest.

D.C. schools would lose about $5 million in the first year in busing reimbursement, according to a spokeswoman for Mayor Adrian M. Fenty (D). Virginia has recouped $31 million in Medicaid dollars over the past five years for services that would no longer be covered, with Fairfax County schools alone projecting a $1.8 million loss next year. That's the equivalent of employing 25 teachers. The county's schools this year face a range of budget cuts that would pare back summer school and raise average class size.

Maryland school officials estimate that nearly $1 million in federal funding would dry up statewide next year under the rule, with the greatest impact in Baltimore, which recouped about $593,000 in one recent year, and Prince George's County, which was reimbursed $106,000.

Educators in states including California, Mississippi and North Carolina wrote the government to protest the rule. Officials of some schools said absorbing such expenses could mean dipping into general education programs or cutting back on school nurses or counselors. In one letter, Virginia state Superintendent Billy K. Cannaday Jr. said school systems will continue to help enroll children in Medicaid and coordinate services but will have to "shift funds from other areas in their budgets to cover the costs or raise taxes if this proposal becomes a reality."

The Centers for Medicare and Medicaid Services proposed the rule in September, and it was made final in December. But congressional Democrats slipped a six-month moratorium into legislation passed before the end of the year.

Dennis G. Smith, director of the federal Center for Medicaid and State Operations, said the change will help reign in a system in which federal auditors have found improper billing in some states. He emphasized that schools will still be reimbursed for direct medical services, such as physical or speech therapy, as well as for transporting children to a doctor's office or therapy session if it is scheduled off campus during the school day.

"This is not about medically necessary services," Smith said. "We will continue to pay for those types of services. Medicaid was being used simply to leverage revenues for activities that had very little to do with serving children on Medicaid. Schools already have responsibility to transport all children, not just Medicaid children, to school. That should not be billed to Medicaid."

Health advocates and Democratic lawmakers criticized the change as a rash shift that ultimately could result in fewer needy children connecting with health services.

"This is a huge change in law," said Sara Rosenbaum, chairman of the Department of Health Policy at the George Washington University School of Public Health and Health Services. "This could have an impact on the number of children enrolled in the program and the number of children who are assisted in getting health care. Whatever concerns there were about schools administering Medicaid . . . are totally outweighed by what [the administration] has done here."

Rep. John D. Dingell (Mich.), the senior Democrat in the House, called on the administration to "reconsider this misguided rule and start working with Congress to better serve and support America's most vulnerable children." Dingell and other lawmakers have introduced a bill to reverse the rule, requiring Medicaid to cover certain administrative costs for schools and the cost of transporting children with disabilities who go to school in specially equipped or staffed buses.

P.J. Maddox, chairman of the Department of Health Administration and Policy at George Mason University, said the conflict highlights the challenge schools face with the growing cost of educating children with disabilities. Federal law requires schools to provide services to disabled students, but the federal government gives schools only a portion of the money needed to cover extra costs. Schools, she said, have turned to Medicaid to help offset expenses.

"This Medicaid change cuts off that help, which leaves the school system holding the bag," Maddox said. "Who pays for it? The school system will have to pay for it."

Medicaid officials contended, in their written response to public comments on the rule, that cash-strapped schools have a "strong incentive to shift costs to Medicaid for activities that would have been performed by schools in the normal course of their operation" and that schools should find other sources for money. In recent years, reports from the inspector general of the Department of Health and Human Services have found that schools inappropriately sought reimbursement for school administrators' salaries, capital costs and even such items as antacids and lice combs.

Educators acknowledged some problems with billing but said Medicaid should tighten rules and offer more guidance, not simply cut off the dollars.

Maryland officials are concerned about the fallout for Baltimore and Prince George's schools.

"It's a lot of impact on the two jurisdictions that have the largest numbers of the neediest children," said Carol Ann Baglin, an assistant state superintendent in Maryland. "They are going to have to take funds from somewhere else in a very tight fiscal time and put them into transportation."

Late last month, Los Angeles school officials went to Capitol Hill to lobby against the rule, saying their school system, the nation's second largest, could lose $10 million a year in reimbursement. John DiCecco, director of the system's community partners and Medi-Cal programs, said he expects to lay off 10 outreach workers who have helped enroll thousands of children in Medicaid.
DiCecco said the system also uses Medicaid funds to encourage nonprofit and community groups to donate to help the schools run health clinics and offer vision and dental screenings.

"There's no question if this goes away, at least in Los Angeles, the health status of children will directly suffer," DiCecco said.

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L.A? MD? NC? MS? Odd how the complainers are overrun with ILLEGAL ALIENS.

North carolina dentist in winston salem NC advertises in spanish -he not only helps illegals kids get on medicaid. They are the only patients he wants.What is never mentioned by politicians is the inflated bills submitted to medicaid which are never questioned just blindly paid by government -this causes the going rates for doctors and dentists to sharply increase and tell people its the ''going rate'' and also insurance companies get huge discounts.A person who is an american ciitzen and pays for example 175.00 for doctor visit for himself or his kid who is not poor enough for medicaid and not rich enough to pay the high premiums for insurance.Blue cross of NC admitted to me that premiums vary from county to county and is more if it has higher illegal alien population and THE INSURANCE COMMISIONERS office verified that the insurance companies are allowed to have different rates for different counties.

True. Premiums/payments both vary county to county.....not to mention state to state. And the ILLEGAL effect insurance just like everything else they come in contact with.

I have no doubt ILLEGAL ALIENS cost taxpayers more now, then U.S. citizens do who are on WELFARE.