School-Based Medicaid Programs Overview
School-Based Medicaid Programs
School Health and Related Services (SHARS) and the Medicaid Administrative Claiming Project (MAC) Medicaid programs are administered by the Texas Health and Human Services Commission (HHSC). SHARS allows local school districts to obtain Medicaid reimbursement for certain health-related services provided directly to children enrolled in special education, while the MAC program allows reimbursement for certain outreach and case management activities.
School Health and Related Services (SHARS) is a Medicaid financing program and is a joint program of the Texas Education Agency and the Texas Health and Human Services Commission (HHSC). SHARS allows local school districts to obtain Medicaid reimbursement for certain health-related services provided to students in special education. Using existing state and local funds as the state match, SHARS providers are reimbursed the federal share of the established reimbursement rate.
School districts receive federal Medicaid money for SHARS services provided to students who meet all four of the following requirements. These students must:
- be Medicaid eligible;
- be under 21 years of age;
- meet eligibility requirements for Special Education described in the Individuals with Disabilities Education Act (IDEA); and
- have Individual Educational Plans (IEPs) that prescribe the needed services.
Current SHARS services include:
- school health services,
- medical services,
- occupational therapy,
- physical therapy,
- psychological services,
- speech therapy,
- personal care services, and
- special transportation.
SHARS services must be provided by qualified staff under contract with or employed by the school district/ssa. Furthermore, the school district must be enrolled as a Medicaid provider in order to bill Medicaid.
Texas Department of Health Services: School Health Program
Division of Health and Safety
Page last modified on 3/21/2013.