This past week several members of the education committee met with attorneys at Drummond Woodsum and learned that Maine schools may be unable to bill approximately $30,000,000 to Medicare that we were able to in the past. While we were told two years ago that it was a federal requirement that we change our policy due to our use of a “bundled rate” system. That is all well and good, but it appears we threw out the baby with the bathwater. Other states appear to be able to still bill for services we now annot.
During a work session this past week we asked a representative for DHHS, who didn’t have a lot of answers, but insisted they were right. This is in spite of the fact that states like Texas and New Hampshire are still billing for school based services that are medically needed for special education students. The Maine DHHS points to the fact that NH is currently being audited (as is our own DHHS). However, preliminary indications are that the NH audit is not finding fault with the billing of the services we are telling our schools they cannot bill for.
The effect of the changes made (prior to this commissioner and governor) is that local school districts in Maine have to pay for the services themselves. The legal requirement to provide the services is still there, but we have apparently closed the door to the funding that should be available to us. Obviously, we need to get to the bottom of this as soon as we can so that we can potentially recoup these funds for our school districts.
The attorney’s at D&W have talked about several states and they believe that we can in fact change our rules in DHHS and be able to do the billing. However, the department is very much against doing so. While this may be due to the interpretation they have made, there is a rumor out there that part of the reason is that the new computer system (this is the second multimillion dollar system in the last 10 years) isn’t set up to do this billing. If indeed we were to find out that this is part of the reason we have made the funding impossible to get, someone’s head should roll! The fact something isn’t easy on one department in not a sufficient excuse for closing the door on $30 million dollars in funding for our schools.
The Education and Cultural Affairs committee will be holding additional work sessions on this issue, and we are trying to get an extension on the time frame for reporting this carry over bill out of committee so that we can really get to the bottom of this issue. At this point I think the majority of the committee is convinced that there is something seriously wrong here. Hopefully we will be able to work within the federal regulations and reinstate the schools ability to bill for these services. Our special education students deserve the support, and it should not fall on the communities to make up for the federal funds if in fact there is a way to access the reimbursement system!