Issues
Parental Consent and IDEA
Back to issuesIssue Summary: Parental Consent and IDEA
Prior to 2006, LEAs were able to assume parental consent for billing Medicaid for Individualized Education Plan (IEP) services based on the application for Medicaid benefits, which stipulates that a beneficiary assigns rights of third-party medical support to the state. This stipulation was interpreted as consent to bill any additional private insurance coverage. In 2006, however, the U.S. Department of Education’s Office of Special Education and Rehabilitative Services (OSERS) added a new parental consent requirement to IDEA for special education services.
The new language, which dictates current parental consent requirements under IDEA per 34 CFR § 300.154(d) (iv) (A), states that a public agency must obtain parental consent "each time that access to public benefits or insurance is sought’’ and is intended to promote both a free education for students and confidentiality. In practice, however, the language means that informed written consent has to be obtained from a parent prior to each time that an LEA submits a claim for a student’s covered health service, even if a specified series of that service has already been authorized in the student's Individualized Education Plan (IEP).
Following the implementation of the 2006 IDEA parental consent regulation, OSERS responded to complaints about the prohibitive administrative burden associated with the frequency of having to obtain parental consent and issued a clarification of the phrase every time to refer to a specified number of services for a specified period of time. However, despite this clarification, the administrative burden and costs associated with obtaining the parental consent necessary to remain in compliance with the requirement prevented many schools from billing Medicaid for services eligible for reimbursement.
On September 28, 2011, OSERS proposed revised guidelines that would alleviate the unintended problems that this 2006 IDEA requirement has posed for LEAs. Under the new proposal, schools would no longer be required—as they currently are under § 300.154(d)(2)(iv)(A)—to obtain parental consent each time that they seek access to public benefits or insurance programs. Rather, the revised guidelines would replace the consent requirement with a one-time written notification requirement and would permit a public agency to use public benefits or insurance programs in which a child participates to provide or pay for services required under Part B of the act without having to obtain parental consent each time the agency seeks access to those benefits or insurance, provided that parental consent requirements imposed under the Family Educational Rights and Privacy Act (FERPA) and § 300.622 have already been met and that written notification has already been given to the child’s parents.
Related News and Events: Parental Consent
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Comments on Proposed Changes to IDEA Parental Consent Regulations in Review
Paradigm HealthCare Services Feb 17, 2012
The U.S. Office of Special Education and Rehabilitation (OSERS) is currently reviewing comments received on its proposed changes to the IDEA parental consent requirements in 34 CFR 300.154 (d)(2)(iv). -
Schools Ask for Easier Access to Medicaid for Special Education Services
Education Week Dec 05, 2011
Education Week has published an article highlighting proposed changes to the IDEA parental consent requirement. It includes information supporting the positive fiscal and administrative impacts this change would have on schools seeking Medicaid reimbursement for direct health services provided to eligible special education students, and features commentary from National Alliance for Medicaid in Education (NAME) Governmental Affairs & Public Relations Committee Chair, John Hill. -
NAME Shares Support Letter Templates for Proposed Parental Consent Change
Paradigm HealthCare Services Nov 14, 2011
The National Alliance for Medicaid in Education (NAME) supports the changes outlined in the proposed revised parental consent regulation and encourages everyone who has been impacted by the current regulation to submit written comments. -
OSERS' Proposed Regulation Change to 34 CFR Part 300 is Posted to Federal Register
Paradigm HealthCare Services Sep 28, 2011
A proposed regulation change to 34 CFR Part 300, dictating Parental Consent requirements under IDEA, has been posted to the Federal Register. The proposed change has the potential to greatly reduce the administrative burdens and associated billing obstacles presented by the current regulation. Comments are being sought through December 12, 2011. -
OSERS' Issues Notice of Proposed Rulemaking (NPRM) for IDEA Part B
Office of Special Education and Rehabilitative Services Sep 06, 2011
U.S. Office of Special Education and Rehabilitative Services releases a NPRM for regulation 300.154(d)(2)(iv), proposing changes to the regulation that dictates parental consent requirements under IDEA Part B. -
U.S. Department of Education Announces Intent to Amend Parental Consent Requirement in IDEA Part B
Paradigm HealthCare Services Aug 26, 2011
In a recently released 'Plan for Retrospective Analysis', the U.S. DOE calls out the parental consent requirement in IDEA Part B as a target for change.
Related Paradigm Publications: Parental Consent
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2011 Legislative and Regulatory Review
Paradigm HealthCare Services Jan 18, 2012
Paradigm's Legislative and Regulatory Review is an annual review of federal and California state legislation and regulation that have impacted, or are projected to impact, school-based Medicaid billing and reimbursement programs; this publication is current at time of release, January 2012. -
Background Brief: Third Party Liability and Other Health Coverage
Paradigm HealthCare Services May 01, 2010
Students with other health coverage (OHC), often referred to as third party liability (TPL), represent a unique challenge for Local Educational Agencies (LEAs) that seek to receive reimbursement for Medi-Cal covered health services through the LEA Billing Option program. This policy brief explores root causes of the OHC/TPL challenge and potential solutions.
Related Library Files: Parental Consent
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34 CFR Part 300: IDEA Part B Regulations
U.S. Department of Education Jul 07, 2010
Children and youth (ages 3-21) receive special education and related services under IDEA Part B; pertinent citations: Subpart D - Evaluations, Eligibility Determination, Individualized Education Programs and Educational Placements 34 CFR 300.300 (Parental Consent) and 301 (Initial Evaluations) -
LEA Medi-Cal Billing Option Program Frequently Asked Questions
California Department of Health Care Services Jun 10, 2010
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Medi-Cal Provider Manual Part 1 - Medi-Cal Program and Eligibility
California Department of Health Care Services May 20, 2010
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Patient Protection and Affordable Care Act (PPACA)
U.S. Congress Mar 23, 2010
Also referred to as the Affordable Care Act (ACA) and 'Health Reform', under the PPACA: 1. most individuals will be required to have health insurance beginning in 2014, 2. individuals who do not have access to affordable employer coverage will be able to purchase coverage through a health Insurance Exchange with premium and cost-sharing credits available to some people to make coverage more affordable (small businesses will be able to purchase coverage through a separate Exchange), 3. employers will be required to pay penalties for employees who receive tax credits for health insurance through the Exchange, with exceptions for small employers, 4. new regulations will be imposed on all health plans that will prevent health insurers from denying coverage to people for any reason, including health status, and from charging higher premiums based on health status and gender, 5. Medicaid will be expanded to 133% of the federal poverty level for all individuals under age 65. Summary of legislation courtesy of Kaiser Family Foundation. -
Individuals with Disabilities Education Act (IDEA)
U.S. Congress Dec 03, 2004
The complete 2004 federal reauthorization of the Individuals with Disabilities Education Act (IDEA). IDEA is a law ensuring services to children with disabilities throughout the nation. IDEA governs how states and public agencies provide early intervention, special education and related services to eligible infants, toddlers, children and youth with disabilities.