Alert #08-2


New York State Office of the Medicaid Inspector General (NYS OMIG)

School/Preschool Supportive Health Services Program (SSHSP/PSHSP)

Medicaid in Education Unit

Issue #08-2

TO:                      All SSHSP/PSHSP Medicaid Providers


FROM:                NYS OMIG SSHSP/PSHSP Medicaid in Education Unit


DATE:                January 25, 2008


SUBJECT:          Pended Speech Therapy and Special Transportation Claims

                           and Provider Certifications


This Medicaid Alert is a follow-up to our Medicaid Alert #08-1, dated 1/10/08.


Please hold on to the Speech and Transportation claims for Medicaid reimbursement until we inform you that we are ready for your claims to be processed. 


We are currently in the process of changing all of the affected rate codes for each school district and county on an individual basis, from pend speech, transportation and counseling claims to deny these claims.  Once this has been completed, all of the pended claims then would need to be reprocessed so that they can actually be denied payment.  This will take at least one CSC cycle. 


We will post a list of all school districts and counties that have been approved to bill Medicaid for the affected claims on the NYSED Medicaid website.  This list will be updated on a weekly basis.  The names of the school districts and counties will be posted once all of the payment logic has been set to Pay, so if your school district or county (for preschool providers) is on the list your affected rate codes have been set to pay eligible claims.


For any questions/comments regarding this alert, please contact your Regional Information Center representative, NYS Education Department Medicaid Coordinators, or NYS OMIG Medicaid in Education Unit staff.

Last Updated: June 5, 2009