Schools bill Medicaid for $9 million Claims, far exceeding past years', are for special ed services

State deadline was Tuesday

Goal is to ease budget crisis, correct mistakes of past

November 30, 1995|By Jean Thompson | Jean Thompson,SUN STAFF

In a race against a state deadline this week, Baltimore schools have sent thousands of Medicaid claims to the state since July, hoping to collect as much as $9 million in sorely needed income and to correct costly mistakes.

In November alone, the school system has billed the state Medicaid program for enough claims to yield about $4.5 million -- more than the school system collected in either of the two previous academic years.

In 1993-1994, the school system collected $3.8 million for the year before; in 1994-1995, $2.7 million was collected for the previous year, school officials said.

Since July, more than 170,000 claims have been filed, all for services for special education students. The state set a deadline of Tuesday this week to finish as many applications as possible for the past school year.

School officials hoped to recover about $9 million in their all-out campaign to get back dollars spent on students' health care in the 1994-1995 school year.

State officials say the money belongs to Baltimore's school system and that it would help ease the $32 million budget shortfall. In the recent past, however, the school headquarters on North Avenue had collected from the state only on a "spotty" basis because of computer errors, lack of resources to solve the problem and poor management of the recovery efforts, state and city school officials said this week.

They anticipate that with the school system's renewed zeal for finding income, a new computer system and cooperation from school staffs and city agencies, Medicaid billings next year might yield $6 million to $10 million.

"I think perhaps the original targets are too ambitious, but it will be a lot better than where we were two months ago," said Richard J. Steinke, assistant state superintendent for special education. "They've done an enormous amount of work."

Mr. Steinke's office oversees school systems' efforts to tap the Medicaid system. The claims seek reimbursement for students' visits with special education experts, speech and physical therapists, psychologists and other health care providers, he said.

Under federal law, school systems bear the cost of providing those services to special education students. If a student is from a low-income family and qualifies for Medicaid, school systems can get some of the money back.

L The federal dollars managed by the state program must be ear

marked to improve special education services and programs.

Baltimore, with 17,000 special education students and more poor children than any other Maryland school system, has long qualified for but never taken full advantage of those dollars, city and state officials said.

"When I came on board, I saw we had done a really spotty job in the past," said Dr. Kathleen Feeley, Baltimore's administrator for special education.

This year, because of computer errors, some claims were billed twice and some not at all, officials determined. There were mix-ups with student identification numbers. Cases lacked documentation. And claims were filed for ineligible students.

State Medicaid officials rejected incorrect claims from the city school system and demanded refunds of some of its payments. They were willing, however, to allow the city to correct its records and win the money back.

"The emphasis was first and foremost on reconstructing records for the last nine months," Mr. Steinke said. Progress was slow at first, but the discovery of its budget crisis this year sparked the rush that has continued through this month.

"Dollars we recover would be used to offset the shortfall," said Henry Raymond, chief financial officer for the school system. The money would be earmarked for special education expenses that have contributed to the shortfall, for school nurse programs and for immunizations for needy students, he said.

About a third of this year's $32 million shortfall -- $11 million -- comes from increased spending on special education, which is required as the city responds to federal court orders for immediate improvements.

At Mayor Kurt L. Schmoke's urging, Superintendent Walter G. Amprey and Dr. Feeley marshaled staffs to revamp the billing system and to research and correct thousands of claims one by one.

Special education workers searched for old bills, hospital records, receipts, teachers' notes -- any paperwork proving that an eligible student received reimbursable health services.

Then, a team of clerks typed furiously to fill a new computer system with the claims. They worked over the past weekend to finish as many claims as possible before the Tuesday deadline and will be allowed to continue in coming months until the billing is up to date, Dr. Feeley said yesterday.

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