School Health and Related Services

The School Health and Related Services (SHARS) program allows Texas school districts (LEAs) and shared service arrangements (SSAs) to request Medicaid reimbursement for certain health-related services. The Admission, Review, and Dismissal (ARD) committee determines SHARS services. Services must be medically necessary and reasonable to ensure that children with disabilities are able to participate in the educational program.

SHARS reimbursement is provided for children who meet all of the following requirements:

  • Are 20 years of age and younger and eligible for Medicaid
  • Meet eligibility requirements for special education described in the Individuals with Disabilities Education Act (IDEA)
  • Have Individualized Education Program (IEPs) that prescribe the needed services

Services covered by SHARS include:

  • Audiology services
  • Counseling
  • Nursing services
  • Occupational therapy
  • Personal care services
  • Physical therapy
  • Physician services
  • Psychological services, including assessments
  • Speech therapy
  • Transportation in a school setting

Qualified personnel who are under contract with or employed by the LEA/SSA must provide SHARS services.

 SHARS Frequently Asked Questions

 

Participation in SHARS   

A district must enroll as an active Medicaid provider for SHARS to become eligible to submit claims and receive reimbursement for SHARS services. The Texas Medicaid fee-for-service provider enrollment form is located on the  Texas Medicaid and Healthcare Partnership (TMHP) website. Additional information about becoming a SHARS Medicaid provider is located on the Texas Health and Human Services Commission website.

 Federal Reimbursement Opportunity for the 2016-17 School Year  

 The Texas Medicaid Provider Procedures Manual

 Code Updates Related to the Texas Medicaid and Healthcare Partnership (TMHP)

Time Sensitive in 2015 - Provider Re-enrollment Requirement

As the result of a federal mandate, all Medicaid providers must periodically re-enroll in the Medicaid program. All SHARS providers enrolled prior to January 1, 2013 who have not re-enrolled in the Medicaid program must do so immediately. Failure to re-enroll may result in termination from the Medicaid program. Terminated providers will not be eligible to receive payment for services rendered.

Learn More

Get Help

  • Call the TMHP Contact Center at 1-800-925-9126, option 2 or the TMHP CSHCN Services Program Contact Center (1-800-568-2413)
  •  Attend a workshop
 

Notice and Consent   

LEAs and SSAs are required to provide notification and obtain consent before accessing a child’s or parent’s public benefits or insurance.
 

Written Notification 

The LEA or SSA must provide written parental notification prior to requesting consent and accessing benefits for the first time and annually thereafter.  Minimally, it must include: 

1. A statement of the parental consent to access public benefits or insurance [34 CFR 300.154(d)(2)(iv)(A)-(B)]:

  •  specify the personally identifiable information that may be disclosed (e.g., records or information about the services),
  •  describe the purpose of the disclosure (e.g., billing for specific IEP services),
  •  identify the agency to which the disclosure may be made (e.g., Medicaid or insurance).

2. A statement of the "no cost" provisions: voluntary participation will not decrease lifetime benefit or incur out-of-pocket expense [34 CFR 300.154(d)(2)(I)-(iii)];

3. A statement that the parents have the right to withdraw their consent at any time (34 CFR part 99 and part 300); and

4. A statement that the withdrawal of consent or refusal to provide consent does not relieve the public agency of its responsibility to ensure that all required services are provided at no cost to the parents [34 CFR 300.154(d)(2)(v)].

      The notification must be written in language understandable to the general public and in the native language of the parent or other mode of communication used by the parent, unless it is clearly not feasible to do so [34 CFR 300.503(c)].

          One-Time Written Consent

        A public agency must obtain parental consent before releasing a child's personally identifiable information for billing purposes to a public benefits or insurance program for the first time.  Minimally, it must include:

        1. A statement of the parental consent to access public benefits or insurance [34 CFR 300.154(d)(2)(iv)(A)-(B)]:

        • specify the personally identifiable information that may be disclosed (e.g., records or information about the services),
        • describe the purpose of the disclosure (e.g., billing for specific IEP services),
        • identify the agency to which the disclosure may be made (e.g., Medicaid or insurance).

          2. A statement indicating that the parent understands and agrees that the public agency may access the child’s or parent’s public benefits or insurance to pay for specific services identified in the child's IEP.

             Non-Regulatory Guidance Regarding Parental Consent for the Use of Public Benefits or Insurance

             

            Compliance Review  

            TEA and the  Health and Human Services Commission (HHSC) cooperate in the oversight of the SHARS program. All SHARS services require documentation to support the medical necessity of the service. TEA in coordination with HHSC conducts desk and on-site reviews of selected LEA's SHARS documentation.

            The purpose of the SHARS review is to:

            • monitor compliance with documentation guidelines,
            • promote quality student services,
            • ensure LEAs and SSAs are adequately documenting health-related services for which Medicaid reimbursement is requested,
            • provide policy clarifications to districts,
            • validate information reported to HHSC by districts,
            • work in cooperation with districts and HHSC to minimize exposure to provider waste, program abuse, and fraud.

             SHARS Compliance Review Guide

             SHARS Self Monitoring Tool

             Federal Health and Human Services; Office of the Inspector General