Indiana Administrative Code › Title 465 - DEPARTMENT OF CHILD SERVICES › Article 2 - CHILD WELFARE SERVICES › Rule 4 - Interstate Compacts on Adoption and Medical Assistance › Section 4-4 - Medical assistance

Current through July 10, 2024
Authority: IC 12-13-5-3
Affected: IC 31-3-5
Sec. 4.
(a) Children
				for whom a party state is committed, in accordance with the terms of an
				adoption assistance agreement, to provide federally aided medical assistance
				under Title XIX of the Social Security Act, are eligible for such medical
				assistance during the entire period for which the agreement is in effect. Upon
				application therefor, the adoptive parents of a child who is the subject of
				such an adoption assistance agreement shall receive a medical assistance
				identification document made out in the child's name. The identification shall
				be issued by the medical assistance program of the residence state and shall
				entitle the child to the same benefits, pursuant to the same procedures, as any
				other child who is covered by the medical assistance program in that state,
				whether or not the adoptive parents are themselves eligible for medical
				assistance.
(b) The identification
				document shall bear no indication that an adoption assistance agreement with
				another state is the basis for its issuance. However, if the identification is
				issued pursuant to such an adoption assistance agreement, the records of the
				issuing state and the adoption assistance state shall show the fact, and shall
				contain a copy of the adoption assistance agreement and any amendment or
				replacement thereof, as well as all other pertinent information. The adoption
				assistance and medical assistance programs of the adoption assistance state
				shall be notified of the issuance of such identification.
(c) A state which has issued a medical
				assistance identification document pursuant to this rule, which identification
				is valid and currently in force, shall accept, process, and pay medical
				assistance claims thereon as it would with any other medical assistance claims
				by eligible residents.
(d) The
				federally aided medical assistance provided by a party state pursuant to this
				rule shall be in accordance with subsections (a) through (c). When a child who
				is covered by an adoption assistance agreement is living in another party
				state, payment or reimbursement for any medical services and benefits specified
				under the terms of the adoption assistance agreement, which are not available
				to the child under the Title XIX medical assistance program of the residence
				state, shall be made by the adoption assistance state as required by its law.
				Any payments so provided shall be of the same kind and at the same rates as
				provided for children who are living in the adoption assistance state. However,
				where the payment rate authorized for a covered service under the medical
				assistance program of the adoption assistance state exceeds the rate authorized
				by the residence state for that service, the adoption assistance state shall
				not be required to pay the additional amounts for the services or benefits
				covered by the residence state.
(e)
				A child referred to in subsection (a), whose residence is changed from one (1)
				party state to another party state, shall be eligible for federally aided
				medical assistance under the medical assistance program of the new state of
				residence.
(f) Medical assistance
				shall be provided consistent with federal law. Services and benefits shall not
				be reimbursed for any amount covered under any insurance or other third party
				medical contract or arrangement held by the child or adoptive parents.
Transferred from the Division of Family Resources ( 470
					 IAC 3-5.3-4 ) to the Department of Child Services ( 465 IAC 2-4-4 ) by P.L.
					 234-2005, SECTION 195, effective July 1,
					 2005.