California Approves Medicaid Reimbursement for Schools Using Live Online Speech Therapy Services

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Medi-Cal now allows educational agencies to request reimbursement for speech therapy services delivered via telemedicine like those offered by PresenceLearning

PresenceLearning

Medi-Cal reimbursement will really help our district and districts across the state.

Starting just in time for the 2016-17 school year, educational agencies in California may request Medi-Cal reimbursement for their use of live, online speech-language pathology assessment and treatment services – like those services provided by PresenceLearning – for Medi-Cal eligible students who have an Individualized Education Plan (IEP) or an Individualized Family Services Plan (IFSP).

“We are excited that California is leading the way in policy to help ensure students with special needs have more equitable access to special services,” said Clay Whitehead, Co-founder and Co-CEO of PresenceLearning. “California children, regardless of where they live, will now have better access to the services they need to thrive.”

Live online delivery of speech pathology services—also known as telepractice or telemedicine—is a mode of service delivery recognized as appropriate by the American Speech Language Hearing Association (ASHA) and supported by decades of peer-reviewed, published research studies showing that it produces the same or better results when compared to onsite delivery. Government policy at the federal and state levels is now catching up. In 2015, the federal Centers for Medicare and Medicaid Services (CMS) clarified their policy on reimbursement for telemedicine services, clearing the way for each state to reimburse for telemedicine services that have parity with face-to-face services.

“We started using PresenceLearning three years ago when we faced speech-language pathologist vacancies and we’ve been so happy with the services and how our students have responded,” said Alice Solis, Director of Support Services at Newman Crows Landing Unified School District. “The ability to receive Medi-Cal reimbursement funds for our use of PresenceLearning will strengthen our district’s capacity to provide students with the materials and resources they need, as well as the professional development our staff needs. Medi-Cal reimbursement will really help our district and districts across the state.”

PresenceLearning’s live, online therapy services provide students with consistent, high-quality services regardless of an agency’s on-site therapist situation. The ability for districts to receive Medi-Cal reimbursement for remotely delivered services means that more California districts can focus on how to best serve students with special needs.

Schools and districts are required by the Individuals with Disabilities Education Act (IDEA) to provide students who have special needs with special education and related services such as speech-language therapy. However, a nationwide shortage of qualified clinicians and challenges particular to California’s geography and demographics—including long commutes to hard-to-reach schools, difficulty attracting professionals to certain areas, and serving large bilingual populations—make it difficult to appropriately staff speech-language pathology programs for on-site services. Telemedicine has been an effective and efficient alternative for several years, but a lack of Medi-Cal reimbursement for services essentially put those districts that chose to use telemedicine at an economic disadvantage—even if it was their only practical option for deploying services to students. With this new billing policy, California schools choosing to use telemedicine will receive the same reimbursement funds as those districts delivering speech therapy assessment and treatment on-site.

In April of 2015, the Centers for Medicare and Medicaid Services (CMS) issued a major clarification of federal policy regarding telemedicine reimbursement, declaring that states are no longer required to submit a separate Service Provider Agreement (SPA) for coverage of telemedicine services—if they reimburse for telemedicine services the same way they reimburse for face-to-face services. Now, 19 states, including California, plus the District of Columbia, have declared that agencies may submit claims for reimbursement for live online speech-language therapy services. Several of these states, like Washington, New Mexico and Maine, have included the full range of IEP-related services delivered via telemedicine in their Medicaid reimbursement policy clarifications.

About PresenceLearning
PresenceLearning (http://www.presencelearning.com) provides live, online special education related services for K-12 students anytime, anywhere. As the leader in the delivery of clinical services via the web, PresenceLearning has provided over one million sessions of speech-language therapy, occupational therapy, behavioral interventions and mental health services, assessments, and early childhood services.

All school leaders want to help their students to succeed, yet the nationwide shortage of clinicians often compromises access to the special services students need for success. Partnering with PresenceLearning connects you with a network of hundreds of rigorously selected clinical professionals via secure, live video. As Rex Miller, Director of Special Education, Bonneville Joint School District 93, says, “It’s pretty powerful.”

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Kati Elliott
KEH Communications
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