Documentation Requirements Summary

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.

 

Documentation that must be on file:

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.

 

 

 



[2] Committee for  Special Education

[3] Committee for Preschool Special Education

[4] The service provider may not use a signature stamp when attesting to the provision of services.  The monthly service report form reporting the date of service and service provided must be signed.