- What is School Health and Related Services (SHARS)?
- School Health And Related Services (SHARS) is a Medicaid financing program and is a joint effort of the Texas Education Agency (TEA) and the Texas Health & Human Services Commission (HHSC). SHARS allows local school districts, cooperatives, and SSA special education programs to obtain Medicaid reimbursement for certain health-related services provided to children in special education.
The services include: assessment, audiology, counseling, nursing services, physician services, occupational therapy, physical therapy, psychological services, personal attendant care service, speech therapy, and transportation in a school setting. These services must be provided by qualified professionals under contract with or employed by the school district/cooperative. Furthermore, the school district/cooperatives must be enrolled as Medicaid providers in order to bill Medicaid.
Using existing state and local special education allocations as the state match, SHARS providers are reimbursed the federal share or approximately 58.05% of the established billing rate. School districts or cooperatives receive federal Medicaid money for services provided to children who meet all four of the following requirements.
These children must:
- Be Medicaid eligible
- Be under age 21
- Be enrolled in Special Education for one or more disabilities
- Have Individual Educational Plans (IEPs) that prescribe the needed services
- How much paperwork is involved?
- TSBS works closely with school administrators and practitioners to design and refine our billing processes to ensure the simplest data collection system with the least amount of time spent completing SHARS billing tickets. We share your commitment to children and ensure that, as much as possible, your providers’ time is spent with children and not paperwork. With any program there is required documentation; Medicaid is no exception. Our clients have found that our online billing systems are easy to use and require the least amount of time possible.
- How do we know which children are Medicaid eligible?
- Part of our job as your billing agency is to identify your Medicaid eligible population. TSBS does this through interface with the Texas Medicaid & Healthcare Partnership (TMHP). TSBS can submit the names of your special education students to TMHP monthly in order to establish the “match” of Medicaid eligible students. Our unique quality assurance system guarantees complete accuracy in identifying Medicaid eligible students and providing that information to school administrators and practitioners for a quicker and more streamlined billing process.
- How do we keep abreast of Texas’ school-based Medicaid program?
- A commitment of the TSBS network is the keeping in close contact with Texas Medicaid & Healthcare Partnership (TMHP), Texas Health & Human Services Commission (HHSC), The Centers for Medicare and Medicaid (CMS), and the Texas Education Agency (TEA) on behalf of the districts we serve. Our practice since 1998 has been to establish a working relationship with state offices to ensure clear and dependable dissemination of information to our districts. Part of our contractual responsibility is to act as a liaison between state and federal offices and the local school district. In short, TSBS stays abreast of Medicaid for you. When immediate dissemination of information is required, the news is passed along to the SPED Director and Staff via phone calls and emails by our expert Program Representatives. Our promise to you is that we will keep you informed.
- Do I have to become a Medicaid “expert”?
- No, that is our role! Since 1998 TSBS has been successful in providing SHARS billing, training and consultative services to school districts in Texas. TSBS provides a strong blend of the two most important experiential levels required for quality school Medicaid administration:
- A solid exposure to the many applications of federal Medicaid legislation and regulations
- An in-depth record of success and trust whereby school boards and local school administrators have seen legal claims maximized with energies of district personnel minimized
- What if we are audited?
- One of the foremost concerns among school districts is the eventuality of an audit. Our successful experience in this arena has proven invaluable to school districts. The personnel of TSBS have consistently and successfully (to the point of no exception) prepared for and completed audit evaluations for state and federal auditors on behalf of hundreds of school districts. Our audit experience guides the claims process throughout, and prepares each school district in such a way that no surprises or failures to comply are ever realized. We see audit-proof performance not as an “add-on” service at the end, but rather as a condition of readiness that is achieved throughout the TSBS SHARS process.
- What revenue code should be used to document SHARS Medicaid reimbursements in the district’s Financial Accountability System?
- It is recommended by the Texas Education Agency (TEA) that school districts should use the revenue code: 5931 Other Federal Revenues. SHARS Medicaid reimbursements received by school districts are considered vendor payments and do not require separate accountability for audit.