​

IEP Service Coordination/Case Management Training

​

SY 24/25

Teaching is a noble profession that shapes the character, intellect and souls of future generations.

St. Elizabeth Ann Seton

Your PGCPS Medicaid Liaisons

Elementary Schools

angela2.davis@pgcps.org

301-780-6726

Angela Davis

Cindy Spiller

Jerilyn Brooks

Middle Schools, Academies, ECC and Regional Schools

cindy.spiller@pgcps.org

301-780-5911

High Schools, Upper Academies, Charter and Online Campus

jerilyn.brooks@pgcps.org

301-780-5912

Medicaid Office Phone Number: 301-952-6349

Why School-Based Medicaid

Federal regulations encourage educational institutions to recover some of its costs from Medicaid for providing services identified in a student’s IEP.

The Medicare Catastrophic Coverage Act

(Public Law PL 100-360 July 1, 1988)

Medicaid Program Impact on PGCPS

Prince George’s County Public Schools has been participating in school-based Medicaid program since 1994, recovering millions throughout the years. Funds generated are utilized to expand and enhance special education and health related services.

How Case Management Relates to IEP Services

IEP Service Coordination/ Case Management

Physical Therapy

Occupational Therapy

1

2

Speech

4

3

Educational

Maryland Medicaid Billing Requirements

• Student must have an active IEP

• Student must be under 21 and enrolled in Medicaid

• Services must be provided by Maryland license/certified practitioner

• Services must be consistent with IEP goals and objectives

• Services must be PROPERLY DOCUMENTED

Summary of Your Responsibilities

What is Service Coordination?

Service Coordination is defined as case management services that assist students in gaining access to services that are required in his or her IEP

The case manager or service coordinator is responsible for monitoring the delivery of services while ensuring the student’s IEP goals and objectives meet the student’s current needs

​

Reference: COMAR 10.09.52.04

IEP Service Coordinator/Case Manager Responsibilities

• Review monthly email from IEP Facilitator regarding outstanding Missing Logs and Parental Consent

• Submit IEP Service logs through Relay the 5th of the following month

• Complete IEP Meeting Notice and Prior Written Notice for all IEP Meetings

IEP Service Coordinator/Case Manager Responsibilities (Cont.)

• Distribute a copy of the Detailed Student Report to the parent/guardian each month

• Notify the school registrar about new students and changes in student’s status

• Update Maryland Online IEP with new students and any changes in student’s status

Billable IEP Coordination Activities

Initial

Comprehensive

Note

IEP Meetings

Quarterly

Progress Note

Periodic

On-Going IEP Service Coordination

Priority Order of Billing

IEP Meetings take priority over all other services rendered within the month

Initials & Periodic Reviews

Initial IEP Meetings

Perform a Multidisciplinary assessment of student

The covered services include convening and conducting an IEP team meeting to:

1

2

Develop an Initial IEP

Reference: COMAR 10.09.52.04

Periodic IEP Meeting

Perform a multidisciplinary re-assessment of student’s IEP status and service needs

Review and revise, as necessary, the student’s IEP

Reference: COMAR 10.09.52.04

Convening and Conducting an IEP team meeting to:

1

2

Reminders for Billing IEP Meetings

• Enter PWN in MD Online within 5 days of the IEP Meeting

• Upload sign in sheet in MD Online

• Scan parental consent when an Initial IEP Meeting takes place or if the student is new to PGCPS

Validation of IEP Meetings and Quarterly Progress Report

The Medicaid Recovery Office has created August service logs for your schools. Your IEP Facilitator/ Medicaid Coordinator will be responsible to validate.

​

No Action is Required from the Case Manager

Validation of IEP Meeting

The Medicaid Recovery Office will create service logs for IEP Meetings. Case Managers must validate in Relay:

IEP Meeting Logs:

• Logs are created based on PWN being in MD Online

​

• Case Manager will validate

​

• If log is not available, case manager is responsible for creating the log in Relay manually

(IEP Facilitators will validate for High School, Charter and Online Campus)

Validation of Quarterly IEP Progress Report

The Medicaid Recovery Office will create service logs for Quarterly IEP Progress Reports. Case Managers must validate in Relay:

Quarterly IEP Progress Report Logs:

• Logs are created based on Quarterly IEP Progress Reports being in MD Online
• Case Manager will validate
• If log is not available, case manager is responsible for creating the log in Relay manually
• Make the log “non-billable” if an IEP Mtg has occurred in same month

​

(IEP Facilitators will validate for High School, Charter and Online Campus)

How to Validate

Moving on to IEP Service Coordination

On-going Service Coordination

• Implementing the IEP by referring the student to direct service providers

• Assessing the quality and quantity of services being provided

• Acting as a central point of contact relating to IEP services for the student

• Coordinating the service delivery

• Assisting the student in gaining access to services specified in the IEP

• Discussing with direct service providers the services needed that are available for the student

On-going Service Coordination (Cont.)

• Informing the student’s parent/guardian of the student's rights and responsibilities in regard to programs and resources required in the IEP

• Following up to identify any obstacles for a student to utilize services

• Performing ongoing monitoring to determine whether the services are being delivered in an integrated fashion as required on the IEP, and meet the student’s current needs

• Providing a student and their parent/guardian with information and direction that will assist them in successfully accessing and using the services required in the IEP

Billing On-Going Service Coordination

At least one contact per month by the service coordinator is required:

​

On the student’s behalf, relating to the student’s progress and regarding IEP goals

With parent or the student (over 6 yrs old)

Documented as a written progress note in Relay

Send copy of Detailed Student Report (found in Relay) home to parent

D

Anatomy of an Acceptable Log

CREDITS: This presentation template was created by Slidesgo, and includes icons by Flaticon, infographics & images by Freepik and content by Swetha Tandri

Sample Log

Avery is making progress towards achieving his math and behavioral IEP goals.

​

He is able to identify numbers and count to 10. He responds well to occasional prompting and redirection in order to achieve his goals.

Avery continues to receive speech/language services and appears to be making progress towards the mastery of his Speech/Language IEP goals.

AND / OR

Avery seems to be responding successfully to his current IEP accommodations of reduced distractions, and assistive technology support.

2

1. Begin with a statement about whether or not the student is making progress on IEP goals

2. Then write something about how the progress is or is not being demonstrated.

​

3. Include a statement on whether the student receives health related services and the progress of the service

4. If there is no related service, comment about how a specific IEP accommodation, consideration or supplemental aid is helping the student progress.

​

Sample Log

2

Example 1: “Sam has made remarkable progress in his IEP goals since the beginning of the school year! He had previously struggled to stay seated during an academic story or activity. He would be unable to answer the questions accurately as he was not able to focus. Now that he is sitting more consistently, he does very well answering”what” and “who” questions and now we are working very diligently with “where” and “when”. “Working for an incentive is a very strong motivator for Sam. The speech therapist reports that his progress is slow; they will continue with the current plan of treatment and continue to encourage Sam to correctly pronounce blends and sounds. Thank you so much for all of your support and hard work with Sam at home, it is evident and much appreciated!”

​

Example 2: “During our phone conversation regarding Brittany’s IEP goals in reading , math and written language progress, we discussed that Brittany’s OT services were begun as prescribed in the revised IEP. Brittany is responding positively to the services and looks forward to the sessions. We will discuss the progress made by next month.”

Liaisons Lessons

1. Case managers/service coordinators must add all assigned students to their caseload in Relay.
2. Please ensure all logs are completed monthly. If a student leaves your school, complete your log for the last month the student attended your school and remove the student from your caseload in Relay. Please do not complete logs for months when you did not service the student.
3. The Notice of IEP and PWN in MD Online should reflect the same date.
4. When a case manager leaves a school or is out for an extended absence, distribute their caseload to the remaining case managers to ensure continuity of service for students.

​

1. When an IEP service is not delivered within the month, complete a non-billable log in Relay.

​

​

​

​

​

​

​

Quarterly IEP Progress Report

(Billing in Relay when the log is not available to validate)

Bill in the month the case manager created the quarterly progress report in MD Online

​

Comments in Relay should state “sent home quarterly IEP progress report to parent…”

Do not bill the report if there are “unmeasurable new goals” in the quarterly progress report you are billing

Periodic IEP Review

(Billing in Relay when the log is not available to validate)

Service Date in Relay calendar must be the same date as the Notice of IEP date found in MD Online

​

Comments in Relay should state “IEP Meeting held for student’s name, we discussed…”

One More Time: What to Bill First

1

IEP Meetings

2

On-going Service Coordination

3

Quarterly IEP Progress Reports

False Claims Act

The False Claims ACT (FCA) prohibits any individual from KNOWINGLY making a false record or submitting false claims regarding a federal health program, such as Medicaid.

This does not include unintentional errors

• PGCPS has adopted Administrative Procedure - 3703 - Education Regarding False Claims Recovery - Medicaid Reimbursement

This Procedure:

• Provides a Compliance Hotline (866-646-2512) and online access for employees to report any suspected fraud
• Prohibits individuals, who report suspected fraud, from retaliation

False Claims Act (31 U.S.C. 3729-3733)

Where Can I Find Information in My Service Portal

​

Parent Signature:

Ron Alsmear

11/16/2024

Date:

Parental Consent

Federal regulations(34 CFR 300.154(d)) require PGCPS to obtain written consent from the parent before billing Medicaid.

​

• Medicaid Parental Consent Form

Scan & email to sas.medicaidfax@pgcps.org

• MA Authorization Page from the IEP

Parent Consent From MD Online

How to Obtain Parent Signature Electronically

• Adobe Fill and Sign

• Parent Consent Form Email/Scanned to Parent

• Maryland Online Electronic Signature

Please keep this slide for attribution

CREDITS: This presentation template was created by Slidesgo, and includes icons by Flaticon, infographics & images by Freepik and content by Swetha Tandri

Annual Parental Notification

​

• Federal regulations require written notification to parents about services billed to Medicaid.
• This notification explains all of the protections available to parents under Part B, as described in 34 CFR 300.154(d)(2)(v) to ensure parents are fully aware of their rights.
• The Medicaid Recovery Office will mail the notification form(s) to parents/guardians annually.

​

No action needed by case manager

Accessing Relay for Training Only

• Go to https://serviceportal.compuclaim.com
• Login to system
• Client ID = MD
• Email = DEMO#
• Password = Medicaid1

Alternative resources

Here’s an assortment of alternative resources whose style fits that of this template: