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Parental Consent to Access Masshealth - Update of Advisory 2013-1


Effective March 2013, the U.S. Department of Education implemented regulations for the Individuals with Disabilities Act (IDEA), Part B, that changed the requirements in IDEA regulations at 34 CFR 300.154(d) related to parental consent to access public health insurance, in Massachusetts, MassHealth (Medicaid).1 The regulations now allow for a one-time consent for accessing a student's MassHealth insurance rather than require parental/guardian (parental) consent each time services change, such as when the student's Individualized Education Program (IEP) is revised annually. This change has made it easier for school districts to access MassHealth while still protecting family and children's rights.

Beginning July 1, 2019, the MassHealth School-Based Medicaid Program (SBMP) will be expanded to support partial payment reimbursement for services that are provided under other specialized plans, in addition to IEPs. The expanded program will allow for payment through MassHealth for services provided to students pursuant to an Individual Health Care Plan (IHCP), an Individualized Family Service Plan (IFSP), a Section 504 plan, or services that are otherwise medically necessary. There are no changes to the current requirements governing payment for services provided pursuant to an IEP. Additionally, under this expanded program, the requirements for one-time parental consent apply, as described below.

To prepare for these changes, the Department encourages schools and districts to communicate with parents whose students are eligible for MassHealth to obtain necessary written consent as early as possible to ensure that it is in place by July 1, 2019. The district may wish to include information about the requirements and the updated consent form with its 2018-2019 school year "back-to-school" documents.

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