The Children's Health Insurance Program provides reimbursement to medical providers for services rendered to a child who meets the eligibility requirements and application requirements of R382-10. The Children's Health Insurance Program provides limited benefits as described in this rule. The Children's Health Insurance Program is not health insurance. A relationship with the Department as the insurer and the enrollee as the insured is not created under the program. Limitation of Abortion Benefits.
Abortion is a covered benefit only if necessary to save the life of the mother.
The Department shall reimburse only providers who contract with the Department to provide services under the program. The Department may require a child to enroll in a health maintenance organization or other managed care organization that contracts with the Department under the program. The Department shall reimburse only for benefits as limited in provider manuals that form part of its contracts with providers. The Department shall reimburse providers according to the fee schedule or schedules that are made part of its contracts with providers. A provider may not bill or collect any additional monies for services rendered pursuant to a contract to provide services under the Children's Health Insurance Program.