Update on SHARS Cost Settlement from Health and Human Services

PDF Version


April 4, 2019


Update on SHARS Cost Settlement from Health and Human Services


Action Required


Please share with appropriate staff and take required actions

The Texas Education Agency (TEA) is providing information that is posted on the Health and Human Services Commission (HHSC) webpage regarding School Health and Related Services (SHARS): https://rad.hhs.texas.gov/sites/rad/files/documents/mac/2017/2017-shars-cost-report-settlement.pdf.

Medicaid services provided by school districts in Texas to Medicaid-eligible students are known as SHARS. The oversight of SHARS is a cooperative effort between the TEA and HHSC. SHARS allow local school districts, including open-enrollment charter schools, to obtain Medicaid reimbursement for certain health-related services documented in a student's Individualized Education Program (IEP). 

For school districts that submitted a 2017 School Health and Related Services (SHARS) cost report, the final settlement is now available for review in the State of Texas Automated Information Reporting System (STAIRS). The superintendent, chief financial officer, business officer or other school district official with legal authority must coordinate with the SHARS primary financial contact to review the 2017 cost report settlement. Only a SHARS primary financial contact has access to STAIRS to enter agreement or disagreement on behalf of the school district official. Failure to act immediately may impact your school district’s Medicaid funding.

Required Actions

  • No later than April 11, 2019: The SHARS primary financial contact and the school district official must log on to STAIRS and review Step 8 of the SHARS cost report.
  • No later than May 1, 2019: The SHARS primary financial contact must enter agreement or disagreement on behalf of the school district official in Step 8 of the SHARS cost report. If agree or disagree is not entered, HHS will determine the district agrees with the cost report settlement and proceed with payout or recoupment as appropriate.  

If the district disagrees with their settlement amount, Texas Health and Human Services Commission’s Rate Analysis Department must receive the district’s hard copy informal review request by May 1, 2019. 

This letter is also a reminder that the timing of this settlement is not the same as in previous years, and this and future settlements will be following a new schedule. In previous years, HHSC Rate Analysis issued SHARS cost report settlement notices in late August. HHSC is now issuing the 2017 settlement notices in April and will begin authorizing the federal payments and recoupments in May. In future years, SHARS settlements will be issued in November. This allows school districts to avoid carrying an account receivable for more than one year and payment and recoupments to occur approximately 10 months earlier than in previous years. 

SHARS Cost Report training time frame has not changed and will still be held annually from January–March. The next SHARS Cost Report training session will be held in January 2020. Key events and dates for SHARS events are detailed below.

SHARS Program Year

Year End Date

Cost Report Collection Date

Payment Date

Payment Date


Sept. 30, 2016

March 31, 2017

Dec. 31, 2018



Sept. 30, 2017

March 31, 2018

Dec. 31, 2019

June 30, 2019


Sept. 30, 2018

March 31, 2019

Dec. 31, 2020

Feb. 28, 2020

For questions about the new schedule, your SHARS cost report or your district’s settlement, please call the SHARS helpline at 512-730-7400 or email us at ra_shars@hhsc.state.tx.us.

For help with STAIRS, contact the Fairbanks Information Center at 888-321-1225 or info@fairbanksllc.com.