Double-Dipping: Special Education and Medicaid

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As I prepare for yet another clash between my values, and those of the public educational system, I could not miss the irony of tonight’s newspaper headline, “MEDICAID FORECAST IS GRIM WITHOUT MAJOR CHANGES.” The article points out that doctors wait years for 14 cents-on-the-dollar reimbursements for important medical services rendered; that the Michigan Medicaid caseload has grown by 162,000 people since 1999 with no sign of leveling off; that “there are fewer dollars available to cover health care for Medicaid patients.” Even Michigan’s Democratic Governor-elect Jennifer Granholm has stated, “Universally, people have come to me and said, ‘Medicaid is broken. It needs to be fixed.’” (The Associated Press, 11-25-2002)

I could help Ms Granholm understand how widely the floodgates have been thrown, but I doubt that my voice would be heard. The aspect of Medicaid with which I deal is this: public schools are encouraged to believe that special education teachers provide medical services, and so public schools are filing claims with Medicaid. These pseudo-claims are actually being paid, and the always-welcome monies are rolling into the school districts — while cardiac surgeons wait years to get paid for real medical services to Medicaid patients.

I presently face an open threat of disciplinary action because I refuse to believe that I am a medical provider, and I refuse to fill out claim forms. Furthermore, I openly and strongly state my belief that such claims are fraudulent and serve to "double-dip" the taxpayers. However, the educational establishment will not allow itself to recognize the lack of logic behind this “special education equals medical services” scam. The "call of the money" beckons.

I have been instructed to note and detail every contact I have, with any general education teacher, who also works with any of the students on my caseload, who qualify for Medicaid:

LST: $$ “Hi there, Mr. Science. The time for the Individual Education Planning Committee (IEPC) meeting for Mary has been changed to after school. See you then.” $$ (note 1/4 hour of service time plus 1—1 hour meeting?)

LST: $$ “Hi, Miss Artclass. How is Freddy paying attention this morning? Ummm….that’s nice.” $$ (note 1/4 hour service time?)

None of these encounters, brief or long, are medically related, or serve medical purposes, yet I am being ordered to bill Medicaid for them. In fact, I have been ordered to over-bill, just in case Medicaid decides to under-pay. The exact wording of the principal’s memo is, “Only one service coordination activity can be approved per student per day. Document all services rendered on the MedBill form. Medicaid covers one service per day and five per twenty days. It is suggested that you write seven or eight in case a few get rejected.” (October 21, 2002)

I sat in the principal’s office, trying to be nice, borrowing from Bartleby, the Scrivener, “I would prefer not to.” (My thanks to John Taylor Gatto for the suggestion.) I tried explaining that I could not, with good conscience, file claims that would double-dip the taxpayer; that the taxpayers were already paying me to check up on Freddy and Mary, and should not have to pay double for the same moment-in-time.

When he asked if I was prepared to accept any repercussions for my refusal to obey, I pointed out that I have, without complaint, accepted punishment during all the years that I have been refusing to file these forms. I explained that the special education director long ago decided that, since I do not file for any $$booty$$, my students do not deserve any additional, or more current, technology. I directed his attention to the Apple IIC and the no-name 286 PC without printer — all the technology provided for my students to use in my classroom. (Should my students be forced to suffer and do without, simply because I have principles that others in the profession lack?)

When the principal asked what I would do if he absolutely insists that I file the claims, I explained that I have already had U.S. Representative Dave Camp’s northern area director visit my classroom to hear my concerns about "Special Education & Medicaid." I explained that my next step would be to file a written complaint with the U.S. House of Representatives and any other agencies I feel appropriate. In the likely event that I will end up taking such action, I will also file complaints will the U.S. Attorney General; with Governor John Engler; with Governor-elect Jennifer Granholm; and with the Michigan Attorney General.

Just as a point of interest, I mentioned the confrontation and this principal’s determination to push me into violating my own conscience, to our union rep. I was not asking for help, but the MEA rep decided to meet with my principal without notifying, or including, me. Following that meeting-minus-me, this fellow-teacher said that the principal had convinced him that since “all the other special education teachers are doing it” and since the amount of work necessary to complete the forms did not appear to be out-of-line, that the union’s position would be that I should do as I have been told.

Ah, I would prefer not to….

Linda Schrock Taylor [send her mail] is an educational consultant, homeschooling mom, and public school special ed teacher. She is available for presentations, inservices, and workshops.

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