Medicaid in Schools

COUNTDOWN CLOCK
Medicaid Re-enrollment Process Deadline
January 10, 2025, 11:59 p.m.
Re-enrollment will begin on October 10, 2024.

FDOE-Sponsored Medicaid Tracking & SDAC Systems

Medicaid Tracking System (MTS) 3.0 - The Medicaid Tracking System (MTS) 3.0 is a web-based application provided by the Florida Department of Education (FDOE) to districts at no cost (does not support enrolled charter or private schools), allowing service providers to document and request reimbursement for services provided to students with disabilities through the Medicaid Certified School Match Program.

MTS 3.0 Features - Providers can document and bill for speech therapy services, physical therapy services, and occupational therapy services, as well as nursing services. Providers can generate personal reports of their documented services. Administrators can create detailed reports related to services documented by providers. Administrators can generate/upload the following files:
  • 270 Medicaid Eligibility Request file for submission to AHCA using two student data files
  • 271 Medicaid Eligibility Response file
  • 837 Professional Health Care Claims (billing) file

Contact MTSSupport@fldoe.org for more information.

Medicaid Tracking System (MTS) 2.0 - MTS 2.0 is a desktop-based (versus web-based) school district Medicaid billing software application (does not support enrolled charter or private schools). It is designed to facilitate a school district's student Medicaid eligibility checks and student Medicaid billing, as performed under the Medicaid Certified School Match Program. MTS 2.0 is provided at no cost to school districts by the Florida Department of Education (FDOE).

MTS 2.0 Features
  • Can bill all service types which are billable under the Medicaid Certified School Match Program.
  • Draws its core data from your School Information System (SIS) via a "Student File" and an optional "Exceptionality File" which are produced by your IT Department on monthly basis for importation into MTS 2.0.
  • Enables automated mass student Medicaid Eligibility checks to be performed monthly. With the received eligibility data, you can generate paper based or PDF based monthly student Medicaid eligibility reports.
  • Streamlined Medicaid billing record entry. To bill a service, you only need to enter Student ID, Service Provider ID, Date of Service, Procedure Code, Diagnosis Code, and Units.
  • You can enter your billable service data from paper service documents, or from electronic service documents (such as Microsoft Word or Excel documents, or PDF documents, etc.).
  • Optionally, you can import service records into MTS 2.0 in bulk from other software applications using a specifically formatted Microsoft Excel file, to avoid having to hand enter that service data into MTS 2.0.

MTS 2.0 Architecture - MTS 2.0 is a Microsoft Windows desktop database application. It is designed for installation in your school district central office's Medicaid department, either as a single-user installation on one computer, or as a multi-user installation on multiple client computers in conjunction with a shared data folder on an IT Department file server. Multi-user installations typically contain up to five users, but more users can be supported.

Technical support on installation and operation of MTS 2.0 is provided by Nanci English, Medicaid in Schools Consultant, Student Support Services Project, nanci.english@fldoe.org.

EMACS – Electronic Medicaid Administrative Claiming System - The EMACS is a random moment sample (RMS) web application which supports Florida public school districts in meeting the requirements of the Florida Medicaid School District Administrative Claiming (SDAC) program. The EMACS is utilized by the EMACS Group, which is composed of very-large, large, medium, and small Florida public school districts. The Group's member districts work cooperatively to complete the quarterly SDAC RMS. By working together on the random moment sample, the EMACS Group spreads the RMS workload proportionately among its member districts. The EMACS Group and the EMACS web application are managed and supported by the EMACS Data Manager. The Florida Department of Education (FDOE) provides the EMACS web application, and the services of the EMACS Data Manager, at no cost to member districts in the EMACS Group. No contract is necessary for a district to become a member of the EMACS Group.

EMACS Features
  • No contract and no cost for a school district to participate.
  • The EMACS web application can be accessed using popular desktop/laptop/tablet web browsers.
  • The EMACS web application and the EMACS Data Manager support the EMACS Group's member school districts end-to-end in the SDAC random moment sample process.

Contact Nanci English, Medicaid in Schools Consultant, Student Support Services Project, nanci.english@fldoe.org for more information.

Legislation

The Agency for Health Care Administration shall reimburse Medicaid providers, in accordance with state and federal law, according to methodologies set forth in the rules of the agency and in policy manuals and handbooks incorporated by reference therein. Requirements are specified in the following sections of the Code of Federal Regulations (CFR), Florida Statute (F.S.) and Florida Administrative Code (F.A.C.):

Parental Consent and Annual Notification
  • 34 CFR Chapter III - Office of Special Education and Rehabilitative Services, Department of Education
  • 34 CFR Part 99 - Family Educational Rights and Privacy
  • 6A-6.03028, F.A.C. - Provision of Free Appropriate Public Education (FAPE) and Development of Individual Educational Plans for Students with Disabilities
Certified Match IDEA Medicaid Maximization

Medicaid Handbooks, Guides, Fee Schedules, and Forms

Medicaid Certified School Match Program Medicaid School District Administrative Claiming Program Archived Medicaid Handbooks, Guides, Fee Schedules, and Forms

Medicaid Implementation and Program Readiness

Contact List Enrollment New Medicaid Contacts Medicaid Web Portal Access Annual Notification and Medicaid Parental Consent Plan of Care Size-Alike Data Maximization of Medicaid Reimbursement

Agency for Health Care Administration (AHCA) and Centers for Medicare & Medicaid Services (CMS) Guidance

AHCA Guidance CMS Guidance

Florida Department of Education (FDOE)/University of South Florida (USF) and US Department of Education Guidance

FDOE Guidance Medicaid in Schools - Tip of the Week US DOE Guidance

AHCA Rate Calculations

School-Based Medicaid Meeting Materials

Medicaid Re-enrollment Process Meeting (10/31/2024) EMACS User Call (5/23/24) Quarterly Call (5/4/22) Medicaid 101 Call (3/30/2022-3/31/2022) Quarterly Call (12/9/21) Medicaid 101 Call (9/1/21 - 9/2/21)

AHCA Conference Call (5/27/21) - Zoom Recording

Medicaid in Schools Virtual Conference (3/2/21-3/3/21) Medicaid 101 Call (11/17/20) Quarterly Call (10/29/20) Quarterly Call (7/9/20) Quarterly Call (4/7/20) Archived 2014-2019 Conference Calls Related to Schools and Medicaid (Click here.)

Important Links

Federal Medical Assistance Percentage (FMAP) for Medicaid and Multiplier

Medicaid and School-Based Services - This page from CMS provides an overview of Medicaid and school-based services as well as links to technical assistance materials and the Technical Assistance Center.

Florida Agency for Health Care Administration (AHCA) is responsible for the administration of the Medicaid program, for the licensure and regulation of health facilities and for providing information to Floridians about the quality of the health care they receive in Florida.

Healthy Kids Corporation (KidCare) arranges health care coverage for Florida's uninsured children.

National Alliance for Medicaid in Education represents the nation's Medicaid and Education agency staff, along with local education agency administrators, with programmatic responsibility for administering Medicaid's Administrative Claiming and Direct Billing of Health Related Service programs in schools.

U.S. Department of Health and Human Services - Office of Inspector General Reports

Shared District Resources

Directories Electronic Signature Policies Examples of ICD-10 codes and ICD-9 to ICD-10 conversions shared by school districts

Archived Annual Schools and Medicaid Meetings

Archived Annual Schools and Medicaid Meetings (Agendas, Presentations, and Handouts)

Archived COVID-19 Medicaid Resources

Archived COVID-19 Medicaid Resources (Emails, Fact Sheets, etc.)