Breathe Easy, Ye Who Rely on Medicaid Reimbursements

So said Health and Human Services Secretary Kathleen Sebelius when she rescinded a final rule that would have taken the . As governor of Kansas, keeping Medicaid alive was one of Sebelius' major platforms, according to OntheIssues.org.

Sebelius warned that neither Congress nor the Bush administration planned to extend a one-time increase in Medicaid funding. If the emergency aid is not renewed, Kansas will be forced to cut its Medicaid budget. Sebelius also complained that federal officials have slowed payments to the states in the wake of Medicare and Medicaid reform efforts. If states are forced to cut Medicaid budgets, numbers of uninsured are sure to increase.

The issue was raised back in September of 2007 when then HHS Secretary Mike Leavitt proposed schools be stripped of federal and state reimbursements of Medicaid-eligible reimbursement costs, such as transporting some students to and from therapy sessions and doctor visits, after the Government Accoutability Office discovered some $3.5 billion in fraudulent claims over the previous five years.

Fraud might be the correct term to use in some cases, but certainly not all, as many cases, some involving schools turned out to be paperwork errors. Still, $3.5 billion is $3.5 billion. As for some the alleged perpetrators, Sebelius and U.S. Attorney General Eric Holder announced that 53 people were indicted for schemes to submit more than $50 million in false Medicare claims.

But penalizing schools didn't sit well with Sebelius. In May, HHS and the Center for Medicare & Medicaid Services issued a proposed rule to rescind the transportation rule as well as other that would limit the ability of states to issue reimbursements to agencies and medical services.

Back to the Basics

By Peggy A. Burns

In the last 10 days, I’ve become aware of decisions and deliberations that have important implications. These newsworthy items provoked considerable thought on my part – I knew they were important...but were they important to school transportation professionals?

One, a U.S. Supreme Court decision in Safford U.S.D. v. Redding, concerned a strip search of a then-13-year old girl who was suspected of possession of over-the-counter medication in violation of school district policy. A second, another U.S. Supreme Court opinion – this, in the case of Forest Grove School District v. TA – held that the Individuals with Disabilities Education Act authorizes reimbursement for private special-education services when a public school fails to provide FAPE and the private-school placement is appropriate, regardless of whether the child previously received special-education services throught the public school. The third item was the testimony of Attorney General Eric H. Holder Jr. concerning proposed legistation – the Matthew Shepard Hate Crimes Prevention Act of 2009 – that would, among other things, create a new Federal criminal hate crimes statute. The bill would strengthen and broaden Federal hate crimes legislation, to cover hate crimes committed because of the victim’s sexual orientation, gender, gender identity, or disability. Currently, such victims can recover money damages under a number of federal and state statutes, and state, local, and tribal criminal laws address widely such crimes.

These are important issues to be sure, and, as informed citizens, school transportation professionals should be aware of them. But, if you’re like me, the more issues that demand your attention – especially in ways that suggest, whether subtly or otherwise – that you should take steps to address them in your professional context – the more Maalox moments you have.

So, I want to challenge my colleagues to focus, still, on “the basics,” the situations which pose regular threats to student safety, which distract you from your other duties, and which compromise your already dwindling budgets. These are the situations that are reflected, day-in and day-out in the headlines and on court dockets: such issues as fighting among students on the school bus; student-to-student harassment and bullying; appropriate choice and use of equipment, services, and trained staff in the transportation of students with and without disabilities; recruiting, maintaining, assessing and training of a competent, productive and competent workforce; effective routing and scheduling. . .and it goes on, and on. My theme is that you need to know a lot, balance and juggle even more, and identify and take necessary measures in a whole host of concerns that demand your daily attention. Be aware of these highly significant and national issues, but don’t let them pose serious distractions for you – at least not until you’ve got all the others well under control.

Peggy Burns is an attorney/consultant with Education Compliance Group, Inc. Peggy can be reached at (888) 604-6141, and by email to ecginc@qwestoffice.net.