Double-Dipping:
Special Education and Medicaid
by
Linda Schrock
Taylor
As I prepare for yet another clash between
my values, and those of the public educational system, I could not miss the
irony of tonight's newspaper headline, "MEDICAID FORECAST IS GRIM WITHOUT MAJOR
CHANGES." The article points out that doctors wait years for 14
cents-on-the-dollar reimbursements for important medical services rendered;
that the Michigan Medicaid caseload has grown by 162,000 people since 1999 with
no sign of leveling off; that "there are fewer dollars available to cover
health care for Medicaid patients." Even Michigan's Democratic Governor-elect
Jennifer Granholm has stated, "Universally, people have come to me and said,
'Medicaid is broken. It needs to be fixed.'" (The Associated Press,
11-25-2002)
I could help Ms Granholm understand how
widely the floodgates have been thrown, but I doubt that my voice would be
heard. The aspect of Medicaid with which I deal is this: public schools are
encouraged to believe that special education teachers provide medical services,
and so public schools are filing claims with Medicaid. These pseudo-claims are
actually being paid, and the always-welcome monies are rolling into the school
districts – while cardiac surgeons wait years to get paid for real medical
services to Medicaid patients.
I presently face an open threat of
disciplinary action because I refuse to believe that I am a medical provider,
and I refuse to fill out claim forms. Furthermore, I openly and strongly state
my belief that such claims are fraudulent and serve to "double-dip" the
taxpayers. However, the educational establishment will not allow itself to
recognize the lack of logic behind this "special education equals medical
services" scam. The "call of the money" beckons.
I have been instructed to note and detail
every contact I have, with any general education teacher, who also works with
any of the students on my caseload, who qualify for Medicaid:
LST: $$ "Hi there, Mr. Science. The
time for the Individual Education Planning Committee (IEPC) meeting for Mary
has been changed to after school. See you then." $$ (note 1/4 hour of service
time plus 1–1½ hour meeting?)
LST: $$ "Hi, Miss Artclass. How is
Freddy paying attention this morning? Ummm….that's nice." $$ (note 1/4
hour service time?)
None of these encounters, brief or long,
are medically related, or serve medical purposes, yet I am being ordered to
bill Medicaid for them. In fact, I have been ordered to
over-bill, just in case Medicaid decides to
under-pay. The exact wording of the principal's memo is, "Only
one service coordination activity can be approved per student per day. Document
all services rendered on the MedBill form. Medicaid covers one service per day
and five per twenty days. It is suggested that you write seven or eight in case
a few get rejected." (October 21, 2002)
I sat in the principal's office, trying to
be nice, borrowing from Bartleby, the Scrivener, "I would prefer not to." (My
thanks to John Taylor Gatto for the suggestion.) I tried explaining that I
could not, with good conscience, file claims that would double-dip the
taxpayer; that the taxpayers were already paying me to check up on Freddy and
Mary, and should not have to pay double for the same moment-in-time.
When he asked if I was prepared to accept
any repercussions for my refusal to obey, I pointed out that I have, without
complaint, accepted punishment during all the years that I have been refusing
to file these forms. I explained that the special education director long ago
decided that, since I do not file for any $$booty$$, my students do not deserve
any additional, or more current, technology. I directed his attention to the
Apple IIC and the no-name 286 PC without printer – all the technology
provided for my students to use in my classroom. (Should my students be forced
to suffer and do without, simply because I have principles that others in the
profession lack?)
When the principal asked what I would do
if he absolutely insists that I file the claims, I explained that I have
already had U.S. Representative Dave Camp's northern area director visit my
classroom to hear my concerns about "Special Education & Medicaid." I
explained that my next step would be to file a written complaint with the U.S.
House of Representatives and any other agencies I feel appropriate. In the
likely event that I will end up taking such action, I will also file complaints
will the U.S. Attorney General; with Governor John Engler; with Governor-elect
Jennifer Granholm; and with the Michigan Attorney General.
Just as a point of interest, I mentioned
the confrontation and this principal's determination to push me into violating
my own conscience, to our union rep. I was not asking for help, but the MEA rep
decided to meet with my principal without notifying, or including, me.
Following that meeting-minus-me, this fellow-teacher said that the principal
had convinced him that since "all the other special education teachers are
doing it" and since the amount of work necessary to complete the forms did not
appear to be out-of-line, that the union's position would be that I should do
as I have been told.
Ah, I would prefer not
to….
November 29, 2002
Linda
Schrock Taylor [send her mail] lives in northern-lower Michigan, where she is a special
education teacher; a free-lance writer; and the owner of "The Learning Clinic,"
where real reading, and real math, are taught effectively and
efficiently.
Copyright © 2002
LewRockwell.com
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