{"formats":[{"name":"JSON","format":"json","url":"\/downloads\/2025\/code-json\/32.1-326.3.json"},{"name":"Plain Text","format":"text","url":"\/downloads\/2025\/code-text\/32.1-326.3.txt"},{"name":"XML","format":"xml","url":"\/downloads\/2025\/code-xml\/32.1-326.3.xml"},{"name":"HTML","format":"html","url":"\/downloads\/2025\/code-html\/32.1-326.3.html"}],"law_id":69227,"edition_id":1,"section_id":69227,"structure_id":13276,"section_number":"32.1-326.3","catch_line":"Special education health services; memorandum of agreement between the Department of Education and the Department of Medical Assistance Services","history":"1999, cc. 967, 1005; 2002, c. 457; 2021, Sp. Sess. I, c. 250.","full_text":"A\n\nThe Department of Medical Assistance Services, in cooperation with the Department of Education, shall, consistent with the biennium budget cycle, examine and revise, as necessary, the regulations relating to the funding and components of special education services.\n\t\t\tAny revisions shall be designed to maximize access to health care for poor children who are eligible for medical assistance services and to assist school divisions in the funding of medically necessary related services by making use of every possible, cost-effective means, Medicaid reimbursement or other program administered by the Department of Medical Assistance Services, including, but not limited to, the State Children’s Health Insurance Plan pursuant to Title XXI of the United States Social Security Act, as approved by the federal Health Care Financing Administration at the time. Any revisions shall be based on the flexibility allowed to the states and be focused on avoiding large costs for acute or medical care and increasing children’s access to health care, and shall include, but need not be limited to:1\n\nRates for services which shall clearly identify that only the federal share shall be reimbursed for the special education health services and shall demonstrate that local governments are funding the state match for the special education health services provided by school divisions.2\n\nThe benefits and drawbacks of allowing school divisions to provide services as Medicaid providers to disabled students.3\n\nThe appropriate credentials of the providers of care, in compliance with federal requirements and with the approval of the Health Care Financing Administration, for special education health services; e.g., licensure by the Board of Education and licensure by the appropriate health regulatory board within the Department of Health Professions.4\n\nDelivery of medically necessary related services for students who are eligible for medical assistance services.\n\t\t\t\tThe services shall be limited to those services which are covered under the then-current state plan for medical assistance services, and may be provided, consistent with federal law and as approved by the Health Care Financing Administration, by a school division participating as a health services provider. Such services shall include, but need not be limited to, speech therapy, including such services when delivered by school speech-language pathologists licensed by the Board of Audiology and Speech-Language Pathology or those individuals who are directly supervised, at least twenty-five percent of the time, by such licensed speech-language pathologists; physical therapy; occupational therapy; psychiatric and psychological evaluations and therapy, including such services when delivered by school psychologists-limited licensed by the Board of Psychology; transportation between the student’s home, the school or other site where health-related services are to be provided on those days when the student is scheduled to receive such services at the school or such other site; and skilled nursing services, such as health assessments, screening activities, nursing appraisals, nursing assessments, nursing procedures, medication assessment, medication monitoring, and medication administration.5\n\nThe role of the Medallion, Medallion II, Options or other managed care programs in regard to the special education health services and coordination with school divisions regarding any required referrals.B\n\nAny funds necessary to support revisions to the special education health services shall be included in the budget estimates for the departments, as appropriate.C\n\nThe Director of the Department of Medical Assistance Services or his designee and the Superintendent of Public Instruction or his designee shall develop and execute a memorandum of agreement relating to special education health services. This memorandum of agreement shall be revised on a periodic basis; however, the agreement shall, at a minimum, be revised and executed within six months of the inauguration of a new governor in order to maintain policy integrity.D\n\nThe agreement shall include, but need not be limited to, (i) requirements for regular and consistent communications and consultations between the two departments and with school division personnel and officials and school board representatives; (ii) a specific and concise description and history of the federal Individuals with Disabilities Education Act (IDEA), a summary of school division responsibilities pursuant to the Individuals with Disabilities Education Act, and a summary of any corresponding state law which influences the scope of these responsibilities; (iii) a specific and concise summary of the then-current Department of Medical Assistance Services regulations regarding the special education health services; (iv) assignment of the specific responsibilities of the two state departments for the operation of special education health services; (v) a schedule of issues to be resolved through the regular and consistent communications process, including, but not limited to, ways to integrate and coordinate care between the Department of Medical Assistance Services’ managed care providers and special education health services providers; (vi) a process for the evaluation of the services which may be delivered by school divisions participating as special education health services providers pursuant to Medicaid; (vii) a plan and schedule to reduce the administrative and paperwork burden of Medicaid participation on school divisions in Virginia; and (viii) a mechanism for informing primary care providers and other case management providers of those school divisions that are participating as Medicaid providers and for identifying such school divisions as Medicaid providers that are available to receive referrals to provide special education health services.E\n\nThe Board of Medical Assistance Services shall cooperate with the Board of Education in developing a form to be included with the Individualized Education Plan (IEP) that shall be accepted by the Department of Medical Assistance Services as the plan of care (POC) and in collecting the data necessary to establish separate and specific Medicaid rates for the IEP meetings and other services delivered by school divisions to students.\n\t\t\tThe POC form shall (i) be consistent with the plan of care required by the Department of Medical Assistance Services of other Medicaid providers, (ii) allow for written updates, (iii) be used by all school divisions participating as Medicaid providers of special education health services, (iv) document the student’s progress, and (v) be integrated and coordinated with the Department of Medical Assistance Services’ managed care providers.F\n\nThe Department of Medical Assistance Services shall consult with the Department of Education in preparing a consent form which (i) is separate from the IEP, (ii) includes a statement noting that such form is not part of the student’s IEP, (iii) includes a release to authorize billing of school-based health services delivered to the relevant student by the school division, and (iv) shall be used by all school divisions participating in Medicaid reimbursement. This consent form shall be made available to the parents upon conclusion of the IEP meeting. The release shall allow for billing of school-based health services by Virginia school divisions to the Virginia Medicaid program and other programs operated by the Department of Medical Assistance Services.G\n\nThe Department of Medical Assistance Services and the Department of Education shall also develop a cost-effective, efficient, and appropriate process to allow school divisions access to eligibility data for students for whom consent has been obtained.H\n\nThe Board of Medical Assistance Services shall, when in compliance with federal law and regulation and approved by the Health Care Financing Administration, also (i) include, in its regulations which provide for reimbursement of school divisions participating in Medicaid as special education health services providers, a provision for reimbursement of mental health services delivered by licensed school psychologists-limited and a provision for reimbursement for services rendered to Medicaid-eligible students of speech-language pathology services delivered by school speech-language pathologists or those individuals who are directly supervised, at least twenty-five percent of the time, by such licensed speech-language pathologists; (ii) revise the limitations, established pursuant to relevant regulations and Virginia’s state plan for medical assistance services, on services delivered by school divisions participating in Medicaid as special education health services providers, in effect on January 1, 1999, for physical therapy, occupational therapy, and speech, hearing, and language disorders when such services are rendered to children who are eligible for special education services and have IEPs requiring such services; (iii) cooperate with the Board of Education in developing a form to be included with the IEP that shall be accepted by the Department of Medical Assistance Services as the plan of care when signed by a physician or, when under such physician’s supervision, his designee; (iv) cooperate with the Board of Education in collecting the data necessary to establish separate and specific rates for the IEP services delivered by school divisions to students with disabilities who are eligible for special education and for medical assistance services; and (v) analyze the data necessary for such rates and establish new rates for reimbursement of IEP meetings based on such data.I\n\nServices delivered by school divisions as participating providers in the Medicaid program or any other program operated by the Department of Medical Assistance Services shall not include any family planning, pregnancy or abortion services.","order_by":null,"text":{"0":{"id":250455,"text":"The Department of Medical Assistance Services, in cooperation with the Department of Education, shall, consistent with the biennium budget cycle, examine and revise, as necessary, the regulations relating to the funding and components of special education services.\n\t\t\tAny revisions shall be designed to maximize access to health care for poor children who are eligible for medical assistance services and to assist school divisions in the funding of medically necessary related services by making use of every possible, cost-effective means, Medicaid reimbursement or other program administered by the Department of Medical Assistance Services, including, but not limited to, the State Children’s Health Insurance Plan pursuant to Title XXI of the United States Social Security Act, as approved by the federal Health Care Financing Administration at the time. Any revisions shall be based on the flexibility allowed to the states and be focused on avoiding large costs for acute or medical care and increasing children’s access to health care, and shall include, but need not be limited to:","type":"section","prefixes":["A"],"prefix":"A","entire_prefix":"A","prefix_anchor":"A","level":1,"next_prefix":"A1"},"1":{"id":250456,"text":"Rates for services which shall clearly identify that only the federal share shall be reimbursed for the special education health services and shall demonstrate that local governments are funding the state match for the special education health services provided by school divisions.","type":"section","prefixes":["A","1"],"prefix":"1","entire_prefix":"A1","prefix_anchor":"A1","level":2,"prior_prefix":"A","next_prefix":"A2"},"2":{"id":250457,"text":"The benefits and drawbacks of allowing school divisions to provide services as Medicaid providers to disabled students.","type":"section","prefixes":["A","2"],"prefix":"2","entire_prefix":"A2","prefix_anchor":"A2","level":2,"prior_prefix":"A1","next_prefix":"A3"},"3":{"id":250458,"text":"The appropriate credentials of the providers of care, in compliance with federal requirements and with the approval of the Health Care Financing Administration, for special education health services; e.g., licensure by the Board of Education and licensure by the appropriate health regulatory board within the Department of Health Professions.","type":"section","prefixes":["A","3"],"prefix":"3","entire_prefix":"A3","prefix_anchor":"A3","level":2,"prior_prefix":"A2","next_prefix":"A4"},"4":{"id":250459,"text":"Delivery of medically necessary related services for students who are eligible for medical assistance services.\n\t\t\t\tThe services shall be limited to those services which are covered under the then-current state plan for medical assistance services, and may be provided, consistent with federal law and as approved by the Health Care Financing Administration, by a school division participating as a health services provider. Such services shall include, but need not be limited to, speech therapy, including such services when delivered by school speech-language pathologists licensed by the Board of Audiology and Speech-Language Pathology or those individuals who are directly supervised, at least twenty-five percent of the time, by such licensed speech-language pathologists; physical therapy; occupational therapy; psychiatric and psychological evaluations and therapy, including such services when delivered by school psychologists-limited licensed by the Board of Psychology; transportation between the student’s home, the school or other site where health-related services are to be provided on those days when the student is scheduled to receive such services at the school or such other site; and skilled nursing services, such as health assessments, screening activities, nursing appraisals, nursing assessments, nursing procedures, medication assessment, medication monitoring, and medication administration.","type":"section","prefixes":["A","4"],"prefix":"4","entire_prefix":"A4","prefix_anchor":"A4","level":2,"prior_prefix":"A3","next_prefix":"A5"},"5":{"id":250460,"text":"The role of the Medallion, Medallion II, Options or other managed care programs in regard to the special education health services and coordination with school divisions regarding any required referrals.","type":"section","prefixes":["A","5"],"prefix":"5","entire_prefix":"A5","prefix_anchor":"A5","level":2,"prior_prefix":"A4","next_prefix":"B"},"6":{"id":250461,"text":"Any funds necessary to support revisions to the special education health services shall be included in the budget estimates for the departments, as appropriate.","type":"section","prefixes":["B"],"prefix":"B","entire_prefix":"B","prefix_anchor":"B","level":1,"prior_prefix":"A5","next_prefix":"C"},"7":{"id":250462,"text":"The Director of the Department of Medical Assistance Services or his designee and the Superintendent of Public Instruction or his designee shall develop and execute a memorandum of agreement relating to special education health services. This memorandum of agreement shall be revised on a periodic basis; however, the agreement shall, at a minimum, be revised and executed within six months of the inauguration of a new governor in order to maintain policy integrity.","type":"section","prefixes":["C"],"prefix":"C","entire_prefix":"C","prefix_anchor":"C","level":1,"prior_prefix":"B","next_prefix":"D"},"8":{"id":250463,"text":"The agreement shall include, but need not be limited to, (i) requirements for regular and consistent communications and consultations between the two departments and with school division personnel and officials and school board representatives; (ii) a specific and concise description and history of the federal Individuals with Disabilities Education Act (IDEA), a summary of school division responsibilities pursuant to the Individuals with Disabilities Education Act, and a summary of any corresponding state law which influences the scope of these responsibilities; (iii) a specific and concise summary of the then-current Department of Medical Assistance Services regulations regarding the special education health services; (iv) assignment of the specific responsibilities of the two state departments for the operation of special education health services; (v) a schedule of issues to be resolved through the regular and consistent communications process, including, but not limited to, ways to integrate and coordinate care between the Department of Medical Assistance Services’ managed care providers and special education health services providers; (vi) a process for the evaluation of the services which may be delivered by school divisions participating as special education health services providers pursuant to Medicaid; (vii) a plan and schedule to reduce the administrative and paperwork burden of Medicaid participation on school divisions in Virginia; and (viii) a mechanism for informing primary care providers and other case management providers of those school divisions that are participating as Medicaid providers and for identifying such school divisions as Medicaid providers that are available to receive referrals to provide special education health services.","type":"section","prefixes":["D"],"prefix":"D","entire_prefix":"D","prefix_anchor":"D","level":1,"prior_prefix":"C","next_prefix":"E"},"9":{"id":250464,"text":"The Board of Medical Assistance Services shall cooperate with the Board of Education in developing a form to be included with the Individualized Education Plan (IEP) that shall be accepted by the Department of Medical Assistance Services as the plan of care (POC) and in collecting the data necessary to establish separate and specific Medicaid rates for the IEP meetings and other services delivered by school divisions to students.\n\t\t\tThe POC form shall (i) be consistent with the plan of care required by the Department of Medical Assistance Services of other Medicaid providers, (ii) allow for written updates, (iii) be used by all school divisions participating as Medicaid providers of special education health services, (iv) document the student’s progress, and (v) be integrated and coordinated with the Department of Medical Assistance Services’ managed care providers.","type":"section","prefixes":["E"],"prefix":"E","entire_prefix":"E","prefix_anchor":"E","level":1,"prior_prefix":"D","next_prefix":"F"},"10":{"id":250465,"text":"The Department of Medical Assistance Services shall consult with the Department of Education in preparing a consent form which (i) is separate from the IEP, (ii) includes a statement noting that such form is not part of the student’s IEP, (iii) includes a release to authorize billing of school-based health services delivered to the relevant student by the school division, and (iv) shall be used by all school divisions participating in Medicaid reimbursement. This consent form shall be made available to the parents upon conclusion of the IEP meeting. The release shall allow for billing of school-based health services by Virginia school divisions to the Virginia Medicaid program and other programs operated by the Department of Medical Assistance Services.","type":"section","prefixes":["F"],"prefix":"F","entire_prefix":"F","prefix_anchor":"F","level":1,"prior_prefix":"E","next_prefix":"G"},"11":{"id":250466,"text":"The Department of Medical Assistance Services and the Department of Education shall also develop a cost-effective, efficient, and appropriate process to allow school divisions access to eligibility data for students for whom consent has been obtained.","type":"section","prefixes":["G"],"prefix":"G","entire_prefix":"G","prefix_anchor":"G","level":1,"prior_prefix":"F","next_prefix":"H"},"12":{"id":250467,"text":"The Board of Medical Assistance Services shall, when in compliance with federal law and regulation and approved by the Health Care Financing Administration, also (i) include, in its regulations which provide for reimbursement of school divisions participating in Medicaid as special education health services providers, a provision for reimbursement of mental health services delivered by licensed school psychologists-limited and a provision for reimbursement for services rendered to Medicaid-eligible students of speech-language pathology services delivered by school speech-language pathologists or those individuals who are directly supervised, at least twenty-five percent of the time, by such licensed speech-language pathologists; (ii) revise the limitations, established pursuant to relevant regulations and Virginia’s state plan for medical assistance services, on services delivered by school divisions participating in Medicaid as special education health services providers, in effect on January 1, 1999, for physical therapy, occupational therapy, and speech, hearing, and language disorders when such services are rendered to children who are eligible for special education services and have IEPs requiring such services; (iii) cooperate with the Board of Education in developing a form to be included with the IEP that shall be accepted by the Department of Medical Assistance Services as the plan of care when signed by a physician or, when under such physician’s supervision, his designee; (iv) cooperate with the Board of Education in collecting the data necessary to establish separate and specific rates for the IEP services delivered by school divisions to students with disabilities who are eligible for special education and for medical assistance services; and (v) analyze the data necessary for such rates and establish new rates for reimbursement of IEP meetings based on such data.","type":"section","prefixes":["H"],"prefix":"H","entire_prefix":"H","prefix_anchor":"H","level":1,"prior_prefix":"G","next_prefix":"I"},"13":{"id":250468,"text":"Services delivered by school divisions as participating providers in the Medicaid program or any other program operated by the Department of Medical Assistance Services shall not include any family planning, pregnancy or abortion services.","type":"section","prefixes":["I"],"prefix":"I","entire_prefix":"I","prefix_anchor":"I","level":1,"prior_prefix":"H"}},"ancestry":[{"id":13276,"edition_id":1,"name":"General Provisions","identifier":"1","label":"article","depth":3,"order_by":1,"parent_id":13275,"metadata":{},"date_created":"2026-06-26 03:44:33","date_modified":"2026-06-26 03:44:33","permalink":{"id":201355,"object_type":"structure","relational_id":13276,"identifier":"1","token":"32.1\/10\/1","url":"\/32.1\/10\/1\/","edition_id":1,"permalink":0,"preferred":1}},{"id":13275,"edition_id":1,"name":"Department of Medical Assistance Services","identifier":"10","label":"chapter","depth":2,"order_by":1,"parent_id":12727,"metadata":{},"date_created":"2026-06-26 03:44:33","date_modified":"2026-06-26 03:44:33","permalink":{"id":201353,"object_type":"structure","relational_id":13275,"identifier":"10","token":"32.1\/10","url":"\/32.1\/10\/","edition_id":1,"permalink":0,"preferred":1}},{"id":12727,"edition_id":1,"name":"Health","identifier":"32.1","label":"title","depth":1,"order_by":1,"parent_id":null,"metadata":{},"date_created":"2026-06-26 03:43:50","date_modified":"2026-06-26 03:43:50","permalink":{"id":201099,"object_type":"structure","relational_id":12727,"identifier":"32.1","token":"32.1","url":"\/32.1\/","edition_id":1,"permalink":0,"preferred":1}}],"structure_contents":[{"id":75748,"structure_id":13276,"section_number":"32.1-323","catch_line":"Department of Medical Assistance Services","url":"\/32.1-323\/","token":"32.1\/10\/1\/32.1-323","metadata":false},{"id":73079,"structure_id":13276,"section_number":"32.1-323.1","catch_line":"Department to submit forecast of expenditures","url":"\/32.1-323.1\/","token":"32.1\/10\/1\/32.1-323.1","metadata":false},{"id":78209,"structure_id":13276,"section_number":"32.1-323.2","catch_line":"Elimination of waiting lists for certain waivers","url":"\/32.1-323.2\/","token":"32.1\/10\/1\/32.1-323.2","metadata":false},{"id":65434,"structure_id":13276,"section_number":"32.1-323.3","catch_line":"Dependents of foreign service members; 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orientation program","url":"\/32.1-331.04\/","token":"32.1\/10\/1\/32.1-331.04","metadata":false},{"id":84036,"structure_id":13276,"section_number":"32.1-331.05","catch_line":"Coordinated specialty care; work group","url":"\/32.1-331.05\/","token":"32.1\/10\/1\/32.1-331.05","metadata":false},{"id":77511,"structure_id":13276,"section_number":"32.1-331.06","catch_line":"Annual review of medications and treatment for sickle cell disease; report","url":"\/32.1-331.06\/","token":"32.1\/10\/1\/32.1-331.06","metadata":false}],"previous_section":{"id":86309,"structure_id":13276,"section_number":"32.1-326.2","catch_line":"Pilot school\/community health centers","url":"\/32.1-326.2\/","token":"32.1\/10\/1\/32.1-326.2","metadata":false},"next_section":{"id":81598,"structure_id":13276,"section_number":"32.1-327","catch_line":"Claim against indigent's estate for payments made","url":"\/32.1-327\/","token":"32.1\/10\/1\/32.1-327","metadata":false},"metadata":false,"official_url":"https:\/\/law.lis.virginia.gov\/vacode\/32.1-326.3\/","history_text":"

This law was first created in 1999. The record of its establishment is cataloged in chapters 967<\/a> and 1005<\/a> of that year\u2019s edition of \u201cActs of Assembly,\u201d the annual state publication listing all changes made to the Code of Virginia in that year. It has been modified 1 time. Those modifications are cataloged by \u201cThe Acts of Assembly,\u201d a state publication, by year and chapter. Those modifications that can be read on the General Assembly\u2019s website will be linked accordingly. That modification is as follows: in 2002, chapter 457<\/a>.<\/p>","references":false,"refers_to":false,"permalink":{"id":201453,"object_type":"law","relational_id":69227,"identifier":"32.1-326.3","token":"32.1\/10\/1\/32.1-326.3","url":"\/32.1-326.3\/","edition_id":1,"permalink":0,"preferred":1},"url":"\/32.1-326.3\/","token":"32.1\/10\/1\/32.1-326.3","dublin_core":{"Title":"Special education health services; memorandum of agreement between the Department of Education and the Department of Medical Assistance Services","Type":"Text","Format":"text\/html","Identifier":"\u00a7 32.1-326.3","Relation":"Code of Virginia"},"html":"\n\t\t\t\t\t\t

A.<\/span> The Department<\/span> of Medical Assistance Services, in cooperation with the Department<\/span> of Education, shall, consistent with the biennium budget cycle, examine and revise, as necessary, the regulations relating to the funding and components of special education services.\n\t\t\tAny revisions shall be designed to maximize access to health care for poor children who are eligible for medical assistance services and to assist school divisions in the funding of medically necessary related services by making use of every possible, cost-effective means, Medicaid reimbursement or other program administered by the Department<\/span> of Medical Assistance Services, including, but not limited to, the State Children’s Health Insurance Plan pursuant to Title XXI of the United States Social Security Act, as approved by the federal Health Care Financing Administration at the time. Any revisions shall be based on the flexibility allowed to the states and be focused on avoiding large costs for acute or medical care and increasing children’s access to health care, and shall include, but need not be limited to: <\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t

1.<\/span> Rates for services which shall clearly identify that only the federal share shall be reimbursed for the special education health services and shall demonstrate that local governments are funding the state match for the special education health services provided by school divisions. <\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t

2.<\/span> The benefits and drawbacks of allowing school divisions to provide services as Medicaid providers to disabled students. <\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t

3.<\/span> The appropriate credentials of the providers of care, in compliance with federal requirements and with the approval of the Health Care Financing Administration, for special education health services; e.g., licensure by the Board<\/span> of Education and licensure by the appropriate health regulatory board<\/span> within the Department<\/span> of Health Professions. <\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t

4.<\/span> Delivery of medically necessary related services for students who are eligible for medical assistance services.\n\t\t\t\tThe services shall be limited to those services which are covered under the then-current state plan for medical assistance services, and may be provided, consistent with federal law<\/span> and as approved by the Health Care Financing Administration, by a school division participating as a health services provider. Such services shall include, but need not be limited to, speech therapy, including such services when delivered by school speech-language pathologists licensed by the Board<\/span> of Audiology and Speech-Language Pathology or those individuals who are directly supervised, at least twenty-five percent of the time, by such licensed speech-language pathologists; physical therapy; occupational therapy; psychiatric and psychological evaluations and therapy, including such services when delivered by school psychologists-limited licensed by the Board<\/span> of Psychology; transportation between the student’s home, the school or other site where health-related services are to be provided on those days when the student is scheduled to receive such services at the school or such other site; and skilled nursing services, such as health assessments, screening activities, nursing appraisals, nursing assessments, nursing procedures, medication assessment, medication monitoring, and medication administration. <\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t

5.<\/span> The role of the Medallion, Medallion II, Options or other managed care programs in regard to the special education health services and coordination with school divisions regarding any required referrals. <\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t

B.<\/span> Any funds necessary to support revisions to the special education health services shall be included in the budget estimates for the departments<\/span>, as appropriate. <\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t

C.<\/span> The Director of the Department<\/span> of Medical Assistance Services or his designee and the Superintendent of Public Instruction or his designee shall develop and execute a memorandum<\/span> of agreement relating to special education health services. This memorandum<\/span> of agreement shall be revised on a periodic basis; however, the agreement shall, at a minimum, be revised and executed within six months of the inauguration of a new governor in order<\/span> to maintain policy integrity. <\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t

D.<\/span> The agreement shall include, but need not be limited to, (i) requirements for regular and consistent communications and consultations between the two departments<\/span> and with school division personnel and officials and school board<\/span> representatives; (ii) a specific and concise description and history of the federal Individuals with Disabilities Education Act (IDEA), a summary of school division responsibilities pursuant to the Individuals with Disabilities Education Act, and a summary of any corresponding state law<\/span> which influences the scope of these responsibilities; (iii) a specific and concise summary of the then-current Department<\/span> of Medical Assistance Services regulations regarding the special education health services; (iv) assignment of the specific responsibilities of the two state departments<\/span> for the operation of special education health services; (v) a schedule of issues<\/span> to be resolved through the regular and consistent communications process, including, but not limited to, ways to integrate and coordinate care between the Department<\/span> of Medical Assistance Services’ managed care providers and special education health services providers; (vi) a process for the evaluation of the services which may be delivered by school divisions participating as special education health services providers pursuant to Medicaid; (vii) a plan and schedule to reduce the administrative and paperwork burden of Medicaid participation on school divisions in Virginia; and (viii) a mechanism for informing primary care providers and other case management providers of those school divisions that are participating as Medicaid providers and for identifying such school divisions as Medicaid providers that are available to receive referrals to provide special education health services. <\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t

E.<\/span> The Board<\/span> of Medical Assistance Services shall cooperate with the Board<\/span> of Education in developing a form to be included with the Individualized Education Plan (IEP) that shall be accepted by the Department<\/span> of Medical Assistance Services as the plan of care (POC) and in collecting the data necessary to establish separate and specific Medicaid rates for the IEP meetings and other services delivered by school divisions to students.\n\t\t\tThe POC form shall (i) be consistent with the plan of care required by the Department<\/span> of Medical Assistance Services of other Medicaid providers, (ii) allow for written updates, (iii) be used by all school divisions participating as Medicaid providers of special education health services, (iv) document the student’s progress, and (v) be integrated and coordinated with the Department<\/span> of Medical Assistance Services’ managed care providers. <\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t

F.<\/span> The Department<\/span> of Medical Assistance Services shall consult with the Department<\/span> of Education in preparing a consent form which (i) is separate from the IEP, (ii) includes a statement noting that such form is not part of the student’s IEP, (iii) includes a release to authorize billing of school-based health services delivered to the relevant student by the school division, and (iv) shall be used by all school divisions participating in Medicaid reimbursement. This consent form shall be made available to the parents upon conclusion of the IEP meeting. The release shall allow for billing of school-based health services by Virginia school divisions to the Virginia Medicaid program and other programs operated by the Department<\/span> of Medical Assistance Services. <\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t

G.<\/span> The Department<\/span> of Medical Assistance Services and the Department<\/span> of Education shall also develop a cost-effective, efficient, and appropriate process to allow school divisions access to eligibility data for students for whom consent has been obtained. <\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t

H.<\/span> The Board<\/span> of Medical Assistance Services shall, when in compliance with federal law<\/span> and regulation and approved by the Health Care Financing Administration, also (i) include, in its regulations which provide for reimbursement of school divisions participating in Medicaid as special education health services providers, a provision for reimbursement of mental health services delivered by licensed school psychologists-limited and a provision for reimbursement for services rendered to Medicaid-eligible students of speech-language pathology services delivered by school speech-language pathologists or those individuals who are directly supervised, at least twenty-five percent of the time, by such licensed speech-language pathologists; (ii) revise the limitations, established pursuant to relevant regulations and Virginia’s state plan for medical assistance services, on services delivered by school divisions participating in Medicaid as special education health services providers, in effect on January 1, 1999, for physical therapy, occupational therapy, and speech, hearing<\/span>, and language disorders when such services are rendered to children who are eligible for special education services and have IEPs requiring such services; (iii) cooperate with the Board<\/span> of Education in developing a form to be included with the IEP that shall be accepted by the Department<\/span> of Medical Assistance Services as the plan of care when signed by a physician or, when under such physician’s supervision, his designee; (iv) cooperate with the Board<\/span> of Education in collecting the data necessary to establish separate and specific rates for the IEP services delivered by school divisions to students with disabilities who are eligible for special education and for medical assistance services; and (v) analyze the data necessary for such rates and establish new rates for reimbursement of IEP meetings based on such data. <\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t

I.<\/span> Services delivered by school divisions as participating providers in the Medicaid program or any other program operated by the Department<\/span> of Medical Assistance Services shall not include any family planning, pregnancy or abortion services. <\/i><\/a><\/p><\/section>","plain_text":" CODE OF VIRGINIA\n\nSPECIAL EDUCATION HEALTH SERVICES; MEMORANDUM OF AGREEMENT BETWEEN THE\nDEPARTMENT OF EDUCATION AND THE DEPARTMENT OF MEDICAL ASSISTANCE SERVICES (\u00a7\n32.1-326.3)\n\nA. The Department of Medical Assistance Services, in cooperation with the\nDepartment of Education, shall, consistent with the biennium budget cycle,\nexamine and revise, as necessary, the regulations relating to the funding and\ncomponents of special education services.\n\t\t\tAny revisions shall be designed to maximize access to health care for poor\nchildren who are eligible for medical assistance services and to assist school\ndivisions in the funding of medically necessary related services by making use\nof every possible, cost-effective means, Medicaid reimbursement or other program\nadministered by the Department of Medical Assistance Services, including, but\nnot limited to, the State Children’s Health Insurance Plan pursuant to\nTitle XXI of the United States Social Security Act, as approved by the federal\nHealth Care Financing Administration at the time. Any revisions shall be based\non the flexibility allowed to the states and be focused on avoiding large costs\nfor acute or medical care and increasing children’s access to health care,\nand shall include, but need not be limited to:\n\n 1. Rates for services which shall clearly identify that only the federal share\n shall be reimbursed for the special education health services and shall\n demonstrate that local governments are funding the state match for the special\n education health services provided by school divisions.\n\n 2. The benefits and drawbacks of allowing school divisions to provide services\n as Medicaid providers to disabled students.\n\n 3. The appropriate credentials of the providers of care, in compliance with\n federal requirements and with the approval of the Health Care Financing\n Administration, for special education health services; e.g., licensure by the\n Board of Education and licensure by the appropriate health regulatory board\n within the Department of Health Professions.\n\n 4. Delivery of medically necessary related services for students who are\n eligible for medical assistance services.\n \t\t\t\tThe services shall be limited to those services which are covered under\n the then-current state plan for medical assistance services, and may be\n provided, consistent with federal law and as approved by the Health Care\n Financing Administration, by a school division participating as a health\n services provider. Such services shall include, but need not be limited to,\n speech therapy, including such services when delivered by school\n speech-language pathologists licensed by the Board of Audiology and\n Speech-Language Pathology or those individuals who are directly supervised, at\n least twenty-five percent of the time, by such licensed speech-language\n pathologists; physical therapy; occupational therapy; psychiatric and\n psychological evaluations and therapy, including such services when delivered\n by school psychologists-limited licensed by the Board of Psychology;\n transportation between the student’s home, the school or other site\n where health-related services are to be provided on those days when the\n student is scheduled to receive such services at the school or such other\n site; and skilled nursing services, such as health assessments, screening\n activities, nursing appraisals, nursing assessments, nursing procedures,\n medication assessment, medication monitoring, and medication administration.\n\n 5. The role of the Medallion, Medallion II, Options or other managed care\n programs in regard to the special education health services and coordination\n with school divisions regarding any required referrals.\n\nB. Any funds necessary to support revisions to the special education health\nservices shall be included in the budget estimates for the departments, as\nappropriate.\n\nC. The Director of the Department of Medical Assistance Services or his designee\nand the Superintendent of Public Instruction or his designee shall develop and\nexecute a memorandum of agreement relating to special education health services.\nThis memorandum of agreement shall be revised on a periodic basis; however, the\nagreement shall, at a minimum, be revised and executed within six months of the\ninauguration of a new governor in order to maintain policy integrity.\n\nD. The agreement shall include, but need not be limited to, (i) requirements for\nregular and consistent communications and consultations between the two\ndepartments and with school division personnel and officials and school board\nrepresentatives; (ii) a specific and concise description and history of the\nfederal Individuals with Disabilities Education Act (IDEA), a summary of school\ndivision responsibilities pursuant to the Individuals with Disabilities\nEducation Act, and a summary of any corresponding state law which influences the\nscope of these responsibilities; (iii) a specific and concise summary of the\nthen-current Department of Medical Assistance Services regulations regarding the\nspecial education health services; (iv) assignment of the specific\nresponsibilities of the two state departments for the operation of special\neducation health services; (v) a schedule of issues to be resolved through the\nregular and consistent communications process, including, but not limited to,\nways to integrate and coordinate care between the Department of Medical\nAssistance Services’ managed care providers and special education health\nservices providers; (vi) a process for the evaluation of the services which may\nbe delivered by school divisions participating as special education health\nservices providers pursuant to Medicaid; (vii) a plan and schedule to reduce the\nadministrative and paperwork burden of Medicaid participation on school\ndivisions in Virginia; and (viii) a mechanism for informing primary care\nproviders and other case management providers of those school divisions that are\nparticipating as Medicaid providers and for identifying such school divisions as\nMedicaid providers that are available to receive referrals to provide special\neducation health services.\n\nE. The Board of Medical Assistance Services shall cooperate with the Board of\nEducation in developing a form to be included with the Individualized Education\nPlan (IEP) that shall be accepted by the Department of Medical Assistance\nServices as the plan of care (POC) and in collecting the data necessary to\nestablish separate and specific Medicaid rates for the IEP meetings and other\nservices delivered by school divisions to students.\n\t\t\tThe POC form shall (i) be consistent with the plan of care required by the\nDepartment of Medical Assistance Services of other Medicaid providers, (ii)\nallow for written updates, (iii) be used by all school divisions participating\nas Medicaid providers of special education health services, (iv) document the\nstudent’s progress, and (v) be integrated and coordinated with the\nDepartment of Medical Assistance Services’ managed care providers.\n\nF. The Department of Medical Assistance Services shall consult with the\nDepartment of Education in preparing a consent form which (i) is separate from\nthe IEP, (ii) includes a statement noting that such form is not part of the\nstudent’s IEP, (iii) includes a release to authorize billing of\nschool-based health services delivered to the relevant student by the school\ndivision, and (iv) shall be used by all school divisions participating in\nMedicaid reimbursement. This consent form shall be made available to the parents\nupon conclusion of the IEP meeting. The release shall allow for billing of\nschool-based health services by Virginia school divisions to the Virginia\nMedicaid program and other programs operated by the Department of Medical\nAssistance Services.\n\nG. The Department of Medical Assistance Services and the Department of Education\nshall also develop a cost-effective, efficient, and appropriate process to allow\nschool divisions access to eligibility data for students for whom consent has\nbeen obtained.\n\nH. The Board of Medical Assistance Services shall, when in compliance with\nfederal law and regulation and approved by the Health Care Financing\nAdministration, also (i) include, in its regulations which provide for\nreimbursement of school divisions participating in Medicaid as special education\nhealth services providers, a provision for reimbursement of mental health\nservices delivered by licensed school psychologists-limited and a provision for\nreimbursement for services rendered to Medicaid-eligible students of\nspeech-language pathology services delivered by school speech-language\npathologists or those individuals who are directly supervised, at least\ntwenty-five percent of the time, by such licensed speech-language pathologists;\n(ii) revise the limitations, established pursuant to relevant regulations and\nVirginia’s state plan for medical assistance services, on services\ndelivered by school divisions participating in Medicaid as special education\nhealth services providers, in effect on January 1, 1999, for physical therapy,\noccupational therapy, and speech, hearing, and language disorders when such\nservices are rendered to children who are eligible for special education\nservices and have IEPs requiring such services; (iii) cooperate with the Board\nof Education in developing a form to be included with the IEP that shall be\naccepted by the Department of Medical Assistance Services as the plan of care\nwhen signed by a physician or, when under such physician’s supervision,\nhis designee; (iv) cooperate with the Board of Education in collecting the data\nnecessary to establish separate and specific rates for the IEP services\ndelivered by school divisions to students with disabilities who are eligible for\nspecial education and for medical assistance services; and (v) analyze the data\nnecessary for such rates and establish new rates for reimbursement of IEP\nmeetings based on such data.\n\nI. Services delivered by school divisions as participating providers in the\nMedicaid program or any other program operated by the Department of Medical\nAssistance Services shall not include any family planning, pregnancy or abortion\nservices.\n\nHISTORY: 1999, cc. 967, 1005; 2002, c. 457; 2021, Sp. Sess. I, c. 250.","edition":{"id":1,"name":"2025","slug":"2025","date_created":"2026-06-21 22:39:22","date_modified":"2026-06-21 22:39:22","current":1,"order_by":1,"last_import":null}}