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Crosby ISD reports sharp declines in SHARS reimbursement estimates; district pursuing appeals and process changes
Summary
District staff reported large reductions in anticipated Medicaid (SHARS) reimbursements for school health-related services, including a revised 2022 payment cut from about $1.3 million to $578,000 and a 2023 revision from $826,000 to $147,000; the district is pursuing formal appeals and changing billing practices to maximize recoveries.
A district presenter summarized a year-long SHARS (School Health and Related Services) update and told trustees the district has seen significant downward revisions in anticipated Medicaid reimbursements tied to the program.
The presenter stated SHARS reimburses Medicaid-eligible students for a range of health-related services documented in individualized education programs (IEPs), including therapy, nursing and specialized transportation. She said participation requires quarterly random-moment time studies (RMTS), interim billing and an annual cost report, and that reimbursement amounts are determined through an annual settlement process.
The presenter recited historic reimbursement amounts and recent revisions: the district recorded $623,000 for the 2018 cost report, $819,000 for 2019, $929,000 for 2020 and $989,000 for 2021. For the 2022 cost report the district had initially expected about $1.3 million but was later revised down to $578,000 (a roughly 56% reduction). For the 2023 cost report the initial estimate was $826,000 and was revised down to $147,000 (an 82% reduction), creating a potential shortfall for the current fiscal year.
The presenter said Crosby ISD is pursuing every available step to restore revenue, including an informal review and now a formal appeal for the 2022 cost report. The district has contracted with Houston ISD (HISD) for assistance with documentation and appeals and said HISD has a hearing date that could inform Crosby ISD's timeline. The presenter said the district is also increasing interim billings, reviewing parental consent forms needed for Medicaid billing and contracting to improve staff training on billing and RMTS participation.
The presenter said the district budgeted conservatively—planning for $700,000 in the current year instead of the higher initial estimate of $826,000—and that the district will await appeal outcomes before recommending budget adjustments.
Trustees thanked the presenter and emphasized the need to advocate with state officials; no vote was taken at the meeting.
All descriptions of SHARS, IEPs and Medicaid reimbursement in this story come from the district presentation; the transcript records the district's reported figures and the fact of a formal appeal but does not include final settlement decisions.
