D.C. Mun. Regs. tit. 5, r. 5-A2901

Current through Register Vol. 71, No. 49, December 6, 2024

Rule 5-A2901 - INVOICE SUBMISSION

2901.1

A provider seeking reimbursement for authorized services shall submit to OSSE or an LEA, as appropriate, invoices for special education services in conformance with the special education service rates and procedures established by chapter 28 of this subtitle.

2901.2

Payments of invoices shall be limited to the services specified and authorized in a student's Individualized Education Program (IEP), a Hearing Officer Determination (HOD) resulting from an Individuals with Disabilities Education Act (IDEA) due process hearing, a court order regarding the student's special education needs, or a service approved in writing by OSSE or the responsible LEA. A Settlement Agreement (SA) shall be accepted as authorization for payment unless it violates applicable federal and local laws and regulations.

2901.3

Invoices shall be processed for payment based upon the invoice processing date, as defined in § 2999. For example, if an invoice is received on March 3, it will be processed as if received on March 5, and undisputed amounts must be paid by April 5. If an invoice is received on March 6, however, it will be processed as if received on March 15, and undisputed amounts must be paid by April 15. Finally, if an invoice is received on March 16, it will be processed as if received on April 5 and undisputed amounts must be paid by May 5.

2901.4

Invoices shall be submitted by mail or hand delivery to OSSE or the LEA responsible for payment. An invoice shall be date stamped the same date received by OSSE or the LEA and, upon contemporaneous request, receipts shall be provided for hand-delivered invoices.

2901.5

An invoice shall include the following information:

(a) Student name, date of birth, and the unique student identification number if one has been assigned;

(b) The name of the District of Columbia agency responsible for placing the student at the nonpublic special education school or program:

(1) The responsible agency for day nonpublic special education schools and programs and related service providers is the LEA that placed the student at the school or program or with the provider for IDEA services; and

(2) For residential nonpublic special education schools and programs there may be more than one (1) responsible agency. Such agencies may include the Department of Youth Rehabilitation Services (DYRS), the Child and Family Services Agency (CFSA), and the Department of Mental Health (DMH);

(c) The name of the LEA responsible for ensuring a free appropriate public education (FAPE);

(d) The tuition rate per diem consistent with this chapter;

(e) The number of tuition days billed for on the invoice;

(f) Specific itemization of related services provided, including the frequency of each service and the unit of service provided on a per hour or per diem basis as appropriate;

(g) The student's Medicaid number (if the student is approved for Medicaid), if provided by the parent or the sending LEA; and

(h) An attendance report, including specific days of attendance and absence, the latter of which are identified as excused or unexcused. All absences will be presumed to be unexcused unless otherwise indicated.

2901.6

The following information shall be submitted for Federal reimbursement to the unit designated by OSSE or the LEA as appropriate:

(a) Date of service delivery;

(b) Type of services (such as speech, occupational therapy, physical therapy, counseling, and psychology);

(c) Duration of services (such as forty (40) minutes or sixty (60) minutes);

(d) Therapy modality (for example, group or individual);

(e) Dated and signed notes of one to two sentences in length that document the degree of measurable progress toward student treatment goals and objectives;

(f) The most recent available copy of the student's IEP currently in effect, if not previously provided. If the IEP is revised, a copy of the most recently available revised portion must be submitted within thirty (30) days or upon submission of the first invoice in which the revised IEP services are billed, whichever occurs first; and

(g) Dates of the student's presence and absence in school.

2901.7

The annual and per diem tuition and related services rates shall be published on the OSSE website at http://www.osse.dc.gov on at least an annual basis. In the case of tuition and related services for which there are no published rates pursuant to 5 DCMR A § 2845.1, a nonpublic special education school or program or related service provider providing services shall obtain from OSSE or the appropriate LEA a written rate confirmation pursuant to chapter 28 of this subtitle prior to submission of an invoice. Should OSSE fail to respond within seven (7) business days of a provider's request for a written rate confirmation, the provider may provide services and then invoice OSSE for payment.

2901.8

A provider shall not submit an invoice based upon a bundled or packaged rate methodology when invoicing the District of Columbia government, unless:

(a) Pursuant to chapter 28 of this subtitle, OSSE has accepted the per diem rate established by another state, or political subdivision within a state, based upon a rate setting methodology that OSSE deems reasonable; and

(b) The bundling of related services within the rate submitted to OSSE is permitted or required by that state or political subdivision.

2901.9

Invoices submitted more than six (6) months after the date the services were provided shall not be accepted unless specifically approved by, and at the discretion of, OSSE or the responsible LEA.

2901.10

A nonpublic special education provider determined to have charged a duplicative fee or a fee in excess of a rate approved chapter 28 of this subtitle of the DCMR shall be held responsible for reimbursement of such funds to OSSE or the LEA paying the invoice.

2901.11

Consistent with chapter 28 of this subtitle, an independent related services provider may not invoice OSSE directly unless services are specifically mandated by an IEP, settlement agreement, HOD, or court order.

2901.12

A third party service provider that subcontracts with a nonpublic special education school or program or related services provider shall do business with the LEA regarding costs of services and may not bill OSSE directly, unless specified by an IEP, settlement agreement, HOD, or court order.

2901.13

A provider may not invoice OSSE for services associated with any form of homebound instruction without proof of prior written approval from the responsible LEA and OSSE. OSSE shall determine the applicable rates for such services on case-by-case basis for each individual student.

2901.14

A provider may invoice solely for special education and/or related services, specified in a student's IEP, HOD, or court order or a service approved in writing by OSSE or the LEA paying for a service.

2901.15

The first billing day for a student shall be the first full day of attendance at the nonpublic special education school or program or the first day related services are provided by a related services provider.

2901.16

A nonpublic school or program shall provide a copy of any invoice submitted to OSSE to an LEA upon request.

D.C. Mun. Regs. tit. 5, r. 5-A2901

Final Rulemaking published at 59 DCR 7495, 7496 (June 22, 2012)

Authority: Sections 3(b)(8) and (11) of the State Education Office Establishment Act of 2000, effective October 21, 2000 (D.C. Law 13-176; D.C. Official Code § 38-2602(b)(8) and (11)) (Supp. 2011); sections 101 et seq. of the Placement of Students with Disabilities in Nonpublic Schools Amendment Act of 2006, effective March 14, 2007 (D.C. Law 16-269; D.C. Official Code §§ 38-2561.01 et seq.) (2011 Supp.); and Mayor's Order 2007-149 (June 28, 2007).