Texas Schools Face Repayment Demands for Decade-Old Medicaid Billing Errors

After a 2017 government audit found billing mistakes, the Texas Health and Human Services Commission (HHSC) is telling more than 500 school districts they need to repay the money they got through the SHARS (School Health and Related Services) Medicaid reimbursement program. The study looked at claims that Austin ISD and Dallas ISD made in 2011. It found 238 cases where service costs were coded wrong.

HHSC told the affected districts on December 10 and gave them the choice of paying back the full amount, using the money to pay for future claims, or setting up a six-week payment plan. 

Schools are required by law to provide medical services, like therapy and screenings, to special education students who are qualified for Medicaid. SHARS funds help pay for these services.

The Centers for Medicare and Medicaid Services (CMS) told HHSC to return $16.2 million because of this. The repayment was put off for years because of appeals, but the agency is now going forward with getting the money.

The amounts that districts have to return range from $100 to over $800,000. Many schools are already having trouble with budget cuts. Pete Pape, who is the Chief Financial Officer of Leander ISD, was worried about the stress. The district now owes more than $99,000 and has a $13 million loss this year. Pape said, "You can only bend so far before you start breaking or cutting important programs."

The timing of these returns adds to the financial stress on districts that are already dealing with tight budgets and rising costs. This makes people wonder how schools will continue to provide essential services while facing these new financial demands.

‍