Welcome to the Dallas ISD SHARS Department Frequently Asked Questions (FAQs) page.
Q: What is the SHARS program?
A: SHARS are direct medical services and transportation services available to children who are 20 years of age or younger, enrolled in Medicaid and are eligible to receive services under the Individuals with Disabilities Education Act (IDEA). The services must be included in the child's individualized education program (IEP) established under IDEA.
Q: What criteria must a child meet for the district to bill Medicaid under the SHARS program?
A: SHARS Reimbursement is provided for students who meet all the following requirements:
- Be Enrolled in a public school’s special education program
- Be 20 years of age and younger
- Have an IEP, documenting medical necessity or a prescription for services.
- Have a disability or chronic medical condition
- Be Medicaid Eligible
Q: Could billing SHARS cause a child to exceed any “cap” or lifetime maximum on their Medicaid benefits?
A: There is no lifetime benefit cap for SHARS services provided so long as the services are medically necessary and documented in the student’s IEP. The services provided to the client at the school do not affect the type or amount of Medicaid services the client receives outside the school setting
Q: Are parents required to complete any documentation regarding SHARS?
A: In accordance with the IDEA and the Federal Family Educational Rights and Privacy Act (FERPA), schools are required to obtain parental consent prior to disclosing personally identifiable student information maintained in a student’s education record and are also required to obtain parental consent prior to billing Medicaid for SHARS services. Dallas ISD obtains consent during annual ARD proceedings. Consent may be revoked at any time.
Q: Does SHARS affect Third-Party benefits?
A: Texas Medicaid instituted third party liability (TPL) policy requirements using the “pay and recover later” method for School Health and Related Services (SHARS) providers on October 1, 2017. Using the pay and recover TPL process for SHARS means that Medicaid pays the school district for services before third party reimbursement is sought. The state is permitted a three-year lookback period to seek recovery claims. If the third-party insurance denies a claim for an acceptable reason, no further action is taken.
Parents or guardians will not incur out-of-pocket costs as a result of this notice, because Texas Medicaid pays co-payments and deductibles associated with private insurance. Lifetime benefits of private insurance could be affected depending on the policy or agreement parents or guardians have with the insurance company. Additional parent consent is not required.
For more information regarding Third-Party Benefits please click here.
If you have additional questions that are not answered here, please contact us at 972-581-4372.