CONCORD — Gov. Chris Sununu made common cause with public school superintendents over a Medicaid rule change that could end up costing local districts millions of dollars. In a letter to school superintendents written Sept. 27, Sununu said he was directing Health and Human Services Commissioner Jeff Meyers to dig into the issue and provide school districts with background and guidance on the issue.
At stake are hundreds of thousands of dollars in Medicaid payments to schools, now in limbo because of a federal rule change. The new rule requires that Medicaid payments must be made to medically certified providers: RNs, MDs and PhDs. Schools are commonly reimbursed by Medicaid for special education services, but what services are provided for any particular child is commonly determined by special ed teachers, occupational and physical therapists, school administrators, and parents.
Frank Sprague, chairman of the Claremont school board, said, “We’d be devastated by the agreement (if the rule stands). It’s a moving target, but it could be more than half a million dollars in lost funding.”
Spending on special ed goes up and down throughout the school year as children move into and out of the district, or their need for services changes. Sprague described the Medicaid reimbursement as “a big six-figure number we may not be getting back this year” and said the rule change would devastate not only Claremont, but Newport and other similar districts with high special ed populations.
In 2017 Sununu signed a bill expanding Medicaid coverage to all students eligible to receive Medicaid services. That allowed school districts to bill Medicaid for services they provide to children with disabilities. At the same time, those services are mandated by federal law, which requires school districts to provide an education to all students regardless of disability. Schools provide disability-related services up front and are reimbursed up to 50 percent of their costs by Medicaid.
“We recognize that Medicaid is a critical program for many of New Hampshire’s children and that schools often serve as key providers of medical services for those students,” Sununu wrote in his letter to the superintendents.
On Aug. 27, 2019, the NH Department of Health and Human Services issued an Emergency Rule to keep the schools in compliance with the new federal law, while also keeping the funding from being cut off. Commissioner Meyers wrote, “This is a serious issue that could threaten the State’s participation in the Medicaid program.”
In addition to losing school funding, the State could face penalties from the federal government for noncompliance.
Meyers’ plan, as described in his letter, will be to bring together school administrators, treatment providers and other school professionals to meet over the next 155 days “to close the gaps between qualified treatment providers and school professionals who have the qualifications to provide medical services under the Medicaid program. This work may include amending the State Plan, seeking legislative changes and working with New Hampshire licensing boards.”