In addition to documenting medical necessity, it is important to have a process to obtain parental consent.
Parental consent (or student consent, if the student is age 18 or older) not only confers permission to provide diagnostic and treatment services within the school, but it is also required to bill the student’s health insurance plan, including Medicaid, for the services provided.
Therefore, high rates of parental consent are critical to making school-based Medicaid billing work for sustainable funding. The more parents who provide consent, the higher Medicaid reimbursement will be, since school districts cannot bill Medicaid without consent to do so.
Parental consent also facilitates the sharing of information between healthcare providers and education agencies under state and federal privacy laws, including the Health Insurance Portability and Accountability Act (HIPAA) and the Family Educational Rights and Privacy Act (FERPA).
Parental consent processes — and the implications for families and school reimbursement — vary by state. It is important to carefully consider state options and engage a range of stakeholders to ensure a robust parental consent process that works for all parties.
Parent education can help clarify how participating in the consent process can affect the availability of a range of health care services inside and outside schools.