| To: | School Supportive Health Services Program (SSHSP) Providers |
| From: | Steven Wright, Medicaid Coordinator |
| Date: | April 22, 2011 |
| Subject: | SSHSP Billing |
In accordance with Medicaid Alert 11-02, school districts, counties and §4201 schools may bill for school supportive health services with a date of service on or after September 1, 2009. Claims must be supported by documentation that comports to the requirements outlined in the claiming and billing guidance documents posted on the Medicaid-in-Education website and identified in mandatory SSHSP relevant employee compliance in-person and online training. Refer to Medicaid Alert 11-01 for specific guidance on claiming Targeted Case Management under SSHSP.
In accordance with the NYS Compliance Agreement with the Centers for Medicare and Medicaid Services (CMS), the New York State Education Department (SED) implemented a SSHSP relevant employee compliance training program. SED is required to train school district, county and §4201 school relevant employees to ensure that they are aware of all applicable laws, regulations and standards of conduct for federal participation in the Medicaid program. The term “relevant employee” is defined in the June 2, 2010 memo titled, “Tracking Medicaid-in-Education Relevant Employees” which can be found on the Medicaid-in-Education website. The mandatory relevant employee in-person training sessions began in June 2010 and online training was first made available in November 2010.
Although school districts, counties and §4201 schools may resume billing for School Supportive Health Services at this time, Education Department staff are currently reviewing the relevant employee training database to ensure Medicaid providers are in compliance with the relevant employee training requirement. School districts, counties and §4201 schools that are not in compliance with this requirement will be contacted and their SSHSP claims will be pended until they demonstrate compliance with this requirement. Appropriately documented claims submitted by school districts, counties and §4201 schools that have met the mandatory training requirement will be forwarded for payment beginning with cycle 1765, as outlined in the 2011 Monthly Claiming and Billing calendar on the Medicaid-in-Education website.
Questions regarding the relevant employee database or SSHSP billing may be directed to your local Regional Information Center representative or the NYS Education Department, Medicaid-in-Education Unit at medined@nysed.gov.