Documentation requirements necessary to claim
Medicaid for the provision of Health Related Support Services are included
below and on the Charts on Pages 38 and 39.
New York State laws mandate that all
supporting documentation must be retained for six (6) years from the date the
services were paid.
ü
Referral
to the CSE[2]
and/or the CPSE[3] as per Part 200 of the Commissioner's
Regulations.
ü
Individualized
Education Program
(IEP) Related Services must be on the student's IEP.
ü Certification/Licensure of staff providing the service (authorized staff is
indicated on the charts on Pages 38 and 39).
ü Provider Agreement and Statement of Reassignment completed by outside contractors (see Page 10).
ü Consent for Release of Information for any students eligible for Supplemental
Security Income (see Page 10).
ü Medical Referrals for Medical Specialist Evaluation, Audiological
Evaluations, and Speech Evaluations
ü Medical Recommendation/Order for Physical Therapy, Occupational Therapy,
Skilled Nursing Services and Speech Services.
Orders can be faxed provided that they are signed by the physician and
are legible.
ü "Under the Direction of" documentation
for appropriate speech services (see page 14 and
sample form in Appendix C-11).
ü Supervision or Direction by a licensed
professional, where appropriate.
ü
Monthly
Service Reports to include date of service, service provided,
service provider signature[4] and
the date signed (sample
forms are in Appendix C-7 & 8).
ü Progress notes signed and dated by
service provider. A
minimum of quarterly progress notes is required for each service except skilled
nursing being claimed. The progress
notes must address the goals and/or objectives indicated in the student’s IEP
and copies need to be maintained in accordance with existing document retention
requirements. In the alternative,
consistent with SED regulations, schools will inform the parents of children
with disabilities of their child’s progress in meeting annual goals, at least
as often as student’s without special needs. The notification must include an
assessment of sufficient progress to enable the student to achieve the goals by
the end of the year. Supporting
documentation must be retained in accordance with existing documentation
retention requirements.
ü Special Transportation must be on the IEP and
documented per page 24 in
this Guidebook. (Deputy Commissioner Rebecca Cort’s
2005 Memorandum on Special Transportation in Appendix A).
ü Targeted Case Management (TCM)
-
IEPs and CSE minutes, where available, for the four IEP
reviews, and
-
Documentation of the assigned service coordinator and
service coordination notes for Ongoing Service Coordination (see sample
documentation in Appendix C 13).
-
Parental notification.