Kinney & Associates, Inc.


N. B. Court cases are only included as examples. There are many other cases, some with later dates, that may alter the conclusion that can be reached. We are not responsible for the inaccuracies that may be included and caution the reader to verify all information. This presentation is the property of Kinney & Associates, Inc. and can not be used without permission. For permission email

Medicaid History Year IDEA History
Passage of Medicaid Title XIX of the Soc. Sec. Act 1965  
Requirement to Provide Children's Health Care Added to Medicaid Law. EPSDT 1967  
EPSDT" Start July, 1969 1969  
First Federal "EPSDT" Regulations Effective. Issued November, 1971. 1972  
  1973 Rehabilitation Act of 1973 - 504 Children.
  1975 The Education For All Handicapped Children Act of 1975 passed. In 1991 Renamed to The Individuals with Disabilities Education Act. P.L. 94-142 Requires Related Services, Prohibits Supplanting, thus Requires Medicaid to Pay.
Department of Health and Human Services Office of inspector General Created 1976  
Massachusetts uses Medicaid For SEA "Related Services" in ICF/MR 1978  
  1979 Law establishing the United states Department of Education enacted. Effective May, 1980
Department of Health Education and Welfare becomes The Department of Health and Human Services May 1980

Federal Medicaid issues "EPSDT, A Guide For Educational Programs"

Region II issues State Operation Letter 91-51 "Medicaid Funding of Services Provided in Schools". 1981  
Pres. Regan adds " Katie Becket" option to Medicaid.

HCFA disallowes MA education claims.

Massachusetts litigates Federal Medicaid over disallowance of claims for SEA " Related Services" in ICF/MR. 1983  
1st District issues ruling in favor of MA - 8/27/1985 1985  
  1986 Congress clarifies Medicaid to pay for related services P.L. 99-457.
Supreme Court rule in favor of Massachusetts in use of Medicaid case.  Contains entire history of MA case.

Medicare Catastrophic Act mandates coverage of IEP SBS

Congress expands EPSDT Definition to all coverable services regardless of a state's program limits. 1989  
 Current SBS programs start in NY and MA 1990 NY court case - Medicaid must pay before school. Detsel v. Sullivan

States begin replacing State Education aid with federal Medicaid matching funds.

Federal Medicaid issues regulation stating Medicaid must cover related services. 1992  
  1996 Florida Case Hunter v. Chiles Medicaid pays before LEA.  Link to NLS, Inc. list of related cases
Wisconsin Law requiring Medicaid to cover related services

Title XXI of the Soc. Sec. Act. created.

HCFA issues August 1997 Technical Assistance Guide on Medicaid and School Health

1997 Amendment to IDEA clarify Medicaid is responsible before LEA.. see KINNEY Analysis

July , 1997 US DOE letter  to Wisconsin on parental consent and the Medicaid application.

Skubel, et al. v. Thomas, et al.,  Connecticut Case

HCFA Moratorium on Bundled Rates, etc. 1999 Final Regs. issued as result of 1997 IDEA. Contain specific Medicaid and insurance requirementsSee side by side analysis. Complete regs
GAO Report on Medicaid in Schools-Improper Payments Demand HCFA Oversight

GAO Letter Report on Michigan Contracting

April OIG isssues: Corporate Responsibility and Corporate Compliance: A Resource for Health Care Boards of Directors
Oklahoma DAB Decision 2004 2004 IDEA, CEO Responsibilities
  2006 August 14 Final Regulations
  2007 John Hill letter on Medicaid Requirements

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