Medicaid Overview

Tips from the Special Education Section: Reminders to the Field

Special Education Medicaid Reimbursement Entries

Please share the following information concerning Medicaid reimbursement with your business office and Special Education accounting personnel.

The Special Education office has recieved several inquiries regarding the reporting of Special Education Medicaid Reimbursement. Guidance is found in the Accounting Mannual for Public School Districts, page 7-61 posted at http://www.k12.wa.us/safs/INS/ACC/1314/1314_SDAM_Complete.pdf#Chapter7.

The Washington Health Care Authority no longer provides the full local portion of Medicaid reimbursement payments for school districts. The state pays 40% of the local match needed for Medicaid reimbursement, the balance is paid by the district. The district cannot be reimbursed for any Medicaid eligible services prior to paying the district's portion of the match through the Intergovernmental Transfer (IGT) process. The Center for Medicaid Services (CMS) will not allow the state to disburse any of the Medicaid reimbursement to a district unless the full amount of the match is on hand at the state. Therefore, districts must provide the remaining 60% of the local match to the Health Care Authority before they can receive reimbursement through the IGT.

The payment to HCA for Medicaid reimbursement is recorded as follows:

General Ledger Account Subsidiary Ledger Account Required Account Title Applicable Fund Debit Credit
330 No Due From Other Governmental Units GF 30
240 No Cash on Deposit GF 30
To record the payment to the HCA for Medicaid reimbursement. This would be done through a warrant or a wire transfer.

For every $100 of Medicaid reimbursement, $50 is from the federal Department of Health and Human Services (paid though the state Health Care Authority), $20 is from the state Health Care Authority and $30 is from the distirct.

The Medicaid reimbursement from HCA is recorded as follows:

General Ledger Account Subsidiary Ledger Account Required Account Title Applicable Fund Debit Credit
240 No Cash on Deposit GF 100
330 No Due From Other Governmental Units GF 30
960 4321 Revenue GF 20
960 6321 Revenue (Medicaid Reimbursement) GF 50
To record the receipt of payment from the HCA.

Districts should not record Special Education Medicaid match payments to Programs 21 or 24.

Questions regarding this topic should be directed to Mary Ellen Parrish at (360) 725-6075 or Paul Stone in the School Apportionment and Financial Services at (360) 725-6303.