The Medicaid program was established under Title XIX of the Social Security Act and is jointly funded by the Federal and state governments to provide medical assistance to certain individuals with low income and resources. The Individuals with Disabilities Education Act (IDEA), formerly called the Education of the Handicapped Act, authorized Federal funding to states for programs that impact Medicaid payment for services provided in schools. Under Part B of IDEA, school districts must prepare an Individualized Education Plan (IEP) for each child, which specifies all special education and “related services” needed by the child.
The Medicaid program will pay for some of the “health related services” included in the IEP, if they are among the services specified in Medicaid law and included in the state’s Medicaid Plan.
In Connecticut, the Department of Social Services (State agency) is responsible for administering the Medicaid program. The State agency’s Medicaid Plan includes School Based Child Health (SBCH) services and allows for reimbursement of these services that are provided by or through a Local Education Agency (LEA) to students with special needs pursuant to the IEP.