Committee hears bill to align school Medicaid billing with federal one‑time consent rule

Representative Mary Murray introduced HB 1640 to align state law with the cited federal regulation about parental consent for Medicaid billing in schools. She said the bill is intended to "streamline the process and potentially expedite" reimbursement so districts are not burdened by additional signature requirements that could delay Medicaid‑to‑schools billing.

Becky Wilson, director of governmental relations for the New Hampshire School Boards Association, told the committee the bill "would remove some barriers to participation for the Medicaid to schools program" and emphasized that the Medicaid consent is distinct from IEP consent: "The IEP consents are completely different than the Medicaid to school consent. They have really nothing to do with each other quite honestly." She repeated that the Medicaid consent allows schools to release that a child receives services, not to authorize or deny the service.

Nate Green of the Department of Education answered technical questions, saying the department historically lacked deep research staff but confirmed the department's position that existing procedural safeguards distinguish IEP decision‑making from billing consent. When Representative Freeman asked whether a mid‑year IEP change required a new Medicaid form, witnesses including Becky Wilson and Amy Daniels (New Hampshire Medicaid to Schools Resource Center) explained a new medical order or referral is required for a new service, but if parents had previously consented to Medicaid release, additional Medicaid release forms are frequently not required for amount adjustments. As Wilson put it in an example: "Unless the OT sessions were substantially different...the parent would probably not need to sign another consent for that because there would not need to be a different medical order." She also said parents may withdraw consent at any time, and that districts often treat a withdrawal as a logistically limiting factor for billing.

Committee members pressed practical details: whether districts would lose reimbursement when parents decline consent (witnesses said yes), how much of eligible costs Medicaid typically reimburses (witnesses said rates vary and deferred detailed rate questions to DHHS), and whether the bill might inadvertently require multiple separate consents for closely related services (witnesses cautioned it could become cumbersome if crafted poorly). No formal action or vote was taken; the hearing was closed with the committee collecting testimony for later consideration.

Next steps: the committee may request technical clarifications from DHHS on reimbursement rates and consider amendments to clarify the interplay between IEP modifications, medical orders, and parental consent.