KRS § 199.5954 — KY Code / Title XVII / Chapter 199 / Section 199.5954
199.5954 State medical assistance for special-needs adoptee
Status: in_force

199.5954 State medical assistance for special-needs adoptee.

(1) A child with special needs residing in this state, who is the subject of an adoption

assistance agreement with another state, shall be entitled to receive medical

assistance from this state upon the filing in the Department for Community Based

Services, Cabinet for Health and Family Services, a certified copy of the adoption

assistance agreement obtained from the adoption assistance state. In accordance

with regulations of the Department for Medicaid Services, Cabinet for Health and

Family Services, the adoptive parents shall be required at least annually to show that

the agreement is still in force or has been renewed.

(2) The Department for Medicaid Services, Cabinet for Health and Family Services

shall consider recipients of medical assistance pursuant to this section as any other

recipient of medical assistance under the laws of this state and shall process and

make payment on claims on account of the recipient in the same manner and

pursuant to the same conditions and procedures as for other recipients of medical

assistance.

(3) The Department for Medicaid Services, Cabinet for Health and Family Services

shall provide coverage and benefits for a child who is in another state and who is

covered by an adoption assistance agreement made by the Department for

Community Based Services, Cabinet for Health and Family Services, for the

coverage or benefits, if any, not provided by the residence state. To this end, the

adoptive parents acting for the child may submit evidence of payment for services

or benefit amounts not payable in the residence state and shall be reimbursed

therefor. However, there shall be no reimbursement for services or benefit amounts

covered under any insurance or other third-party medical contract or arrangement

held by the child or the adoptive parents. The Cabinet for Health and Family

Services shall make regulations implementing this subsection. The additional

coverages and benefit amounts provided pursuant to this subsection shall be for

services to the cost of which there is no federal contribution, or which, if federally

aided, are not provided by the residence state. Among other things, the regulations

shall include procedures to be followed in obtaining prior approvals for services in

those instances where required for the assistance.

(4) The submission of any claim for payment or reimbursement for services or benefits

pursuant to this section or the making of any statement in connection therewith,

which claim or statement the maker knows or should know to be false, misleading,

or fraudulent shall be punishable as perjury and shall also be subject to a fine not to

exceed ten thousand dollars ($10,000) or imprisonment for not more than two (2)

years, or both such fine and imprisonment.

(5) The provisions of this section shall apply only to medical assistance for children

under adoption assistance agreements from states that have entered into a compact

with this state under which the other state provides medical assistance agreements

made by this state. All other children entitled to medical assistance pursuant to

adoption assistance agreements entered into by this state shall be eligible to receive

it in accordance with the laws and procedures applicable thereto.