WAC 182-537-0100. Purpose

The medicaid agency pays contracted school districts, educational service districts, charter schools, and tribal schools for school-based health care services provided to medicaid-eligible children who require early intervention or special education and related services consistent with Sections 1903(c) and 1905(a) of the Social Security Act. The agency pays school districts through fee-for-service. Covered services must: (1) Identify, treat, and manage the disabilities of a child who requires early intervention or special education and related services; (2) Be prescribed or recommended by licensed physicians or other licensed health care providers within their scope of practice under state law; (3) Be medically necessary; (4) Be included in the child's current individualized education program (IEP) or individualized family service plan (IFSP); and (5) Be provided in a school setting, the natural environment, an alternate placement in accordance with the Individuals with Disabilities Education Act (IDEA), or by telemedicine.