FERPA Consent for School-Based Medicaid Billing: Balancing Educational Support and Privacy Protection

The Family Educational Rights and Privacy Act (FERPA) is a crucial federal law designed to protect the privacy of students’ education records. In recent years, there has been an increasing intersection between FERPA and school-based Medicaid billing programs. CMS (Centers for Medicare and Medicaid Services) is pushing to change requirements from needing a ‘’parental consent’’ to bill for Medicaid reimbursable services within the schools to requiring a ‘’FERPA consent’’.

Understanding FERPA

FERPA, enacted in 1974, grants parents and eligible students (those who are at least 18 years old or attending postsecondary education) the right to control access to their education records. These records encompass a broad range of information, including grades, transcripts, and other personally identifiable information (PII). FERPA establishes strict guidelines for the release and disclosure of these records, emphasizing the need to obtain consent before sharing sensitive information.

School-Based Medicaid Billing

School-based Medicaid billing programs (which GoClaim helps you optimize) are initiatives that allow schools to seek reimbursement from Medicaid for certain related services provided to eligible students. These services often include speech therapy, occupational therapy, transportation, and other related health services either listed on an IEP (Individualized Education Plan), 504, or IHP (Individualize Health Plan) depending on your state allowances for Free Care.

While these programs can significantly benefit students with diverse needs, they also raise important privacy considerations, as the information required for billing purposes often falls under the umbrella of protected education records.

Importance of FERPA Consent

FERPA’s role in the context of school-based Medicaid billing is paramount. The law serves as a safeguard against the unauthorized disclosure of sensitive student information. Without proper consent, schools risk violating FERPA by sharing personally identifiable information for billing purposes. Obtaining informed consent ensures that parents or eligible students are aware of the information being shared and have the opportunity to control its dissemination.

Challenges and Considerations

While FERPA consent is essential, there are challenges in implementing effective consent processes for school-based Medicaid billing. Some parents may not fully understand the implications of consenting or withholding consent. Additionally, ensuring that consent forms are clear, accessible, and comprehensible poses a significant challenge for educational institutions, especially in states with regulated forms. Striking a balance between obtaining necessary consent and avoiding potential barriers to accessing critical services is crucial.

Best Practices

To address these challenges, educational institutions should adopt best practices for obtaining FERPA consent in the context of school-based Medicaid billing. This includes:

  1. Clear Communication: Schools should communicate with parents and eligible students about the purpose and implications of sharing information for billing purposes. Clear and concise communication can help build trust and understanding. This also starts with ensuring members of the IEP/504 team are well versed in purpose behind obtaining the consent.
  2. Informed Consent Forms: Develop consent forms that are easy to understand, outlining the specific information to be shared, the purpose of sharing, and the protections in place to safeguard privacy. (While ensuring all state guidelines for the forms are followed)
  3. Transparency: Schools should be transparent about their involvement in Medicaid billing programs, explaining how the funds will be used to support the provision of essential related services to students.


FERPA consent plays a pivotal role in navigating the complex intersection of school-based Medicaid billing and student privacy. Striking a balance between providing essential related services and protecting sensitive information requires thoughtful implementation of consent processes. By adopting best practices and promoting transparency, educational institutions can ensure compliance with FERPA while delivering vital support to students with diverse needs.

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