IHCP updates school-based services policy

"In accordance with House Enrolled Act (HEA) 1192, the Indiana Health Coverage Programs (IHCP) is expanding the federal and state educational plans that can authorize coverage of medically necessary school-based Medicaid services.  Effective dates of service on or after July 1, 2023, IHCP reimbursement is available for mandated school-based services when provided pursuant to a Medicaid-enrolled student's educational program or plan as required by the Individuals with Disabilities Education Act (IDEA)  Section 504 of the federal Rehabilitation Act of 1973 (United States Code 29 USC 794)...

Covered services must be medically necessary, included in the Indiana Medicaid State Plan, and listed in (or required for developing) a student's educational program or plan and delivered by a qualified provider within their scope of practice.  Examples might include: 

• Mandated school nursing services by a nurse who is employed by or contracts with a school corporation
• Behavioral health services, including assessments and evaluations
• Speech/language pathology and hearing services
• Physical and occupational therapy
• Applied behavior analysis (ABA) therapy
• Mandated school transportation services on dates of another covered educational plan service"

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