Brief descriptions of procedural clarifications, additions, changes and new resources are described below, along with links to related pages within the i3 system.
Part B: Special Education Updates
Consent/Refusal for Medicaid and/or Private Insurance (Part B Special Education)
- Federal regulations require a one-time written consent from the parent(s) in order for an AEA and LEAs to claim Medicaid reimbursement. The consent is one time while continuously enrolled in the same district or AEA. If the learner changes districts or AEAs, a new consent form is needed for that new district or AEA.
- The process for securing consent for claims was clarified. Parental consent is documented on the Parent Consent/Refusal/Withdrawal for the Area Education Agency (or Local Education Agency) to Share Data and Seek Payment for Individual Educational Program (IEP) Health Related Services form – accessed through the ACHIEVE system
- Important components of the consent, summarized in the revised language and in the form itself include:
- Consent for the AEA or LEA to share data with the Iowa Department of Health and Human Services (DHHS) and to bill for these services.
- Notice that if a learner has private insurance in addition to Medicaid, federal laws require Iowa Medicaid to bill private health insurance coverage after Iowa Medicaid pays the provider.
- Notice that regardless of the payment source, parents will not be expected to pay for services.
- Notice that any authorization given may be revoked by parents at any time.
- The revised guidance is reflected in the Medicaid/Private Insurance section of the Special Education Parent Consent Page – Click here for access
Part C: Early Intervention/Early ACCESS Updates
Early ACCESS Parent Consent
- General revisions for organization and clarity were made to the Early ACCESS Parent Consent Page, which articulates cases where families must give (or not give) their consent for certain actions of the AEA with respect to their infant or toddler with a developmental delay or disability.
- Please note that specific changes to guidance on consent/refusal for Medicaid or Private Insurance have been made and are part of the Parent Consent Page – these changes are described in the section below.
- The revised guidance is reflected in the Early Access Parent Consent Page – Click here for access.
Consent/Refusal for Medicaid and/or Private Insurance (Part C Early ACCESS)
Federal regulations require a one-time written consent from the parent(s) in order for Early ACCESS Regional Grantees (Area Education Agencies), and Child Health Specialty Clinics (Early ACCESS signatory partner) to request reimbursement for services in the IFSP. The consent is one time while continuously enrolled in the same district or AEA. If the learner changes districts or AEAs, a new consent form is needed. This is a change from past procedures that dictated the need for an annual consent and new consent when services substantially changed – this is no longer required.
Important components of the consent include:
- Consent for Early ACCESS to share data with the Iowa Department of Health and Human Services (DHHS) to determine eligibility for Medicaid, and to bill for these services.
- Notice that if a learner has private insurance in addition to Medicaid, federal laws require Iowa Medicaid to bill private health insurance coverage after Iowa Medicaid pays the provider.
- Notice that regardless of the payment source, parents will not be expected to pay for services.
- Notice that any authorization given may be revoked by parents at any time.
Parental consent is documented on the Parent/Guardian Authorization Form for Medicaid Reimbursement for Individualized Family Service Plan (IFSP) Services – accessed through the ACHIEVE system.
- The revised guidance is reflected in the Medicaid/Private Insurance section of the Early Access Parent Consent Page – Click here for access.
Early ACCESS Initial Evaluation
- This section of procedures was revised for organization and clarity of guidance. The definition of the multidisciplinary assessment team was clarified. Language describing the RIOT process, and use of multiple assessment methods was clarified and reorganized. Components of the evaluation process are clarified as well as the necessary criteria for a leaner to be identified as eligible for Early ACCESS services.
- The revised guidance is reflected in the Early Access Initial Evaluation Page – Click here for access.
Resources (Part C)
Early ACCESS Medicaid Authorization Q/A Document (New Resource)
- This document supports the use of the Parent/Guardian Authorization Form for Medicaid Reimbursement for Individualized Family Service Plan (IFSP) Services available in ACHIEVE. The form is used as part of the reimbursement processes between agencies providing Early ACCESS services and Medicaid, as well as between Medicaid and private insurance companies. Sections of the form are explained in detail; commonly asked questions/responses are also provided.
- The resource is available in the Early Intervention Resource Page – Click here for access.
Infant and Toddler Service Coordination Medicaid Matrix (Updated Resource)
- This document is updated for accuracy, is a resource for Early ACCESS Service Coordinators and articulates early intervention services that are/are not billable through Medicaid.
- The resource is available in the Early Intervention Resource Page – Click here for access.
Reviewing the IFSP for Medicaid Reimbursement
- This resource replaces several previous documents that aligned with the previous Legacy system. This new resource is in table format and indicates where key information is located within an ACHIEVE IFSP to support Medicaid reimbursement claims.
- The resource is available in the Early Intervention Resource Page – Click here for access.
IFSP Transition Toolbox for Families
- The Transition Toolbox is designed for Early ACCESS service coordinators to use with families who are going through the transition process with their child from: Early ACCESS (IDEA Part C) to other services or Early ACCESS to special education (IDEA Part B).
- These transition tools were slightly updated with corrected links, and are available in the Early Intervention Resource page as a full document or by “steps.” The documents are fillable forms for use by teams working with families:
Early ACCESS Transition Toolbox
Step 1: Beginning the Transition Process
Step 3: The Transition Planning Meeting
Step 4: Evaluation for Special Education
Step 5: The Individualized Education Program (IEP) Process
Step 6: Putting the IEP Into Action
Child Health Specialty Clinic (CHSC) Nutrition Services Brochure
- Brochures with updated process and referral procedure for Early ACCESS nutrition services are available in the Early Intervention Resource Page. English, French and Spanish versions are available:
CHSC Nutrition Services Brochure (English)