Source: https://www.law.cornell.edu/cfr/text/34/303.520
Timestamp: 2018-01-17 03:32:22
Document Index: 754252120

Matched Legal Cases: ['art 303', '§ 303', '§ 303', '§ 303', '§ 303', '§ 303', '§ 303', '§ 303', '§ 303', '§ 303', '§ 303', '§ 303', '§ 303', '§ 303', '§ 303', '§ 303', '§ 303']

34 CFR 303.520 - Policies related to use of public benefits or insurance or private insurance to pay for Part C services. | US Law | LII / Legal Information Institute
CFR › Title 34 › Subtitle B › Chapter III › Part 303 › Subpart F › Section 303.520
34 CFR 303.520 - Policies related to use of public benefits or insurance or private insurance to pay for Part C services.
(a)Use of public benefits or public insurance to pay for part C services.
(1) A State may not use the public benefits or insurance of a child or parent to pay for part C services unless the State provides written notification, consistent with § 303.520(a)(3), to the child's parents, and the State meets the no-cost protections identified in paragraph (a)(2) of this section.
(2) With regard to using the public benefits or insurance of a child or parent to pay for part C services, the State -
(ii) Must obtain consent, consistent with §§ 303.7 and 303.420(a)(4), to use a child's or parent's public benefits or insurance to pay for part C services if that use would -
(3) Prior to using a child's or parent's public benefits or insurance to pay for part C services, the State must provide written notification to the child's parents. The notification must include -
(i) A statement that parental consent must be obtained under § 303.414, if that provision applies, before the State lead agency or EIS provider discloses, for billing purposes, a child's personally identifiable information to the State public agency responsible for the administration of the State's public benefits or insurance program (e.g., Medicaid);
(ii) A statement of the no-cost protection provisions in § 303.520(a)(2) and that if the parent does not provide the consent under § 303.520(a)(2), the State lead agency must still make available those part C services on the IFSP for which the parent has provided consent;
(iii) A statement that the parents have the right under § 303.414, if that provision applies, to withdraw their consent to disclosure of personally identifiable information to the State public agency responsible for the administration of the State's public benefits or insurance program (e.g., Medicaid) at any time; and
(4) If a State requires a parent to pay any costs that the parent would incur as a result of the State's using a child's or parent's public benefits or insurance to pay for part C services (such as co-payments or deductibles, or the required use of private insurance as the primary insurance), those costs must be identified in the State's system of payments policies under § 303.521 and included in the notification provided to the parent under paragraph (a)(3) of this section; otherwise, the State cannot charge those costs to the parent.
(b)Use of private insurance to pay for Part C services. (1)(i) The State may not use the private insurance of a parent of an infant or toddler with a disability to pay for part C services unless the parent provides parental consent, consistent with §§ 303.7 and 303.420(a)(4), to use private insurance to pay for part C services for his or her child or the State meets one of the exceptions in paragraph (b)(2) of this section. This includes the use of private insurance when such use is a prerequisite for the use of public benefits or insurance. Parental consent must be obtained -
(B) Each time consent for services is required under § 303.420(a)(3) due to an increase (in frequency, length, duration, or intensity) in the provision of services in the child's IFSP.
(ii) If a State requires a parent to pay any costs that the parent would incur as a result of the State's use of private insurance to pay for early intervention services (such as co-payments, premiums, or deductibles), those costs must be identified in the State's system of payments policies under § 303.521; otherwise, the State may not charge those costs to the parent.
(2) The parental consent requirements in paragraph (b)(1) of this section do not apply if the State has enacted a State statute regarding private health insurance coverage for early intervention services under part C of the Act, that expressly provides that -
(3) If a State has enacted a State statute that meets the requirements in paragraph (b)(2) of this section, regarding the use of private health insurance coverage to pay for early intervention services under part C of the Act, the State may reestablish a new baseline of State and local expenditures under § 303.225(b) in the next Federal fiscal year following the effective date of the statute.
(c)Inability to pay. If a parent or family of an infant or toddler with a disability is determined unable to pay under the State's definition of inability to pay under § 303.521(a)(3) and does not provide consent under paragraph (b)(1), the lack of consent may not be used to delay or deny any services under this part to that child or family.
(d)Proceeds or funds from public insurance or benefits or from private insurance.
(1) Proceeds or funds from public insurance or benefits or from private insurance are not treated as program income for purposes of 2 CFR 200.307.
(2) If the State receives reimbursements from Federal funds (e.g., Medicaid reimbursements attributable directly to Federal funds) for services under part C of the Act, those funds are considered neither State nor local funds under § 303.225(b).
(3) If the State spends funds from private insurance for services under this part, those funds are considered neither State nor local funds under § 303.225.
(e)Funds received from a parent or family member under a State's system of payments. Funds received by the State from a parent or family member under the State's system of payments established under § 303.521 are considered program income under 2 CFR 200.307. These funds -
(3) Are considered neither State nor local funds under § 303.225(b).
[ 76 FR 60244, Sept. 28, 2011, as amended at 79 FR 76097, Dec. 19, 2014]
34 CFR 303.211 — State Option to Make Services Under This Part Available to Children Ages Three and Older.
34 CFR 303.13 — Early Intervention Services.
34 CFR 303.520 — Policies Related to Use of Public Benefits or Insurance or Private Insurance to Pay for Part C Services.
34 CFR 303.420 — Parental Consent and Ability to Decline Services.
34 CFR 303.500 — Use of Funds, Payor of Last Resort, and System of Payments.
34 CFR 303.511 — Methods to Ensure the Provision Of, and Financial Responsibility For, Part C Services.