P R E S E N T E D 3 / 5 / 1 4 M . F E N W I C K

SPECIAL EDUCATION MEDICAID INITIATIVE (SEMI)

SEMI: OVERVIEW

Special Education Medicaid Initiative (SEMI) is a school-based federal program that allows the district to bill Medicaid for services that are provided to eligible students.

http://www.state.nj.us/treasury/administration/semi-mac/semi-mac.shtml

SEMI: A SCHOOL-BASED INITIATIVE

This program is of no cost to parents and does not impact a family's Medicaid services, funds or coverage limits in any way.

It is a school-based service initiative.

WHY DO WE PARTICIPATE?

• We are required. • Any district over a given number of eligible students are

required to participate.• Failure to participate can result in loss of funding to

districts.

• It helps bring revenue to the district.• When a student with disabilities who qualifies receives

eligible services, a portion of those services can be billed which brings money to the district.

PARENT CONSENT

We participate by first getting Parent Consent and then keeping track and submitting eligible services for reimbursement. There must be one parent consent on file for up to seven years after a student has withdrawn from the district.

SAMPLE PARENT CONSENT FORM

SCHOOL-BASE SERVICES PROGRAM ACTIVITIES COVERED

• Evaluations• Speech Therapy• Occupational Therapy• Physical Therapy• One IEP Meeting/yr

• Psychological Counseling• Audiology• Nursing• Specialized Transportation

WHAT INFORMATION IS SHARED

• SEMI Reimbursement In order to submit claims, records may be required that include:

• First, Middle, & Last Name• Address• Date of Birth• Student ID• Medicaid ID• Disability• Service Dates• Types of Services Delivered

WHO WILL SEE THIS INFORMATION?

Information about your child’s special education program may be shared with NJ Division of Medicaid Assistance & Health Services, Department of the Treasury, PCG, & NJ Department of Education in order to verify the school-based claims for services.

PARENT CONSENT

If you give a Yes consent:

• Your child receives IEP services• The district is able to

bill Medicaid for eligible services• No changes occur to

your status

If you give a No Consent:

• Your child receives IEP services• The district cannot bill

Medicaid for eligible services• No changes occur to

your status

You can withdraw at any time by contacting the district.

QUESTIONS?

• SEMI NJ WEBSITEhttp://www.state.nj.us/treasury/administration/semi-mac/semi-mac.shtml

• Our PLPS District websitehttp://www.plps-k12.org/Page/2657

• Call or Email Michelle Fenwick 973 835-4722 mfenwick@plps.org Barbara Fontanazza, SEMI Coordinator bfontanazza@plps.org

Thank you