Section 465 IAC 2-4-4 - Medical assistanceAuthority: 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. Department of Child Services; 465 IAC 2-4-4; filed Jan 8, 1991, 3:15 p.m.: 14 IR 1049; readopted filed Jul 12, 2001, 1:40 p.m.: 24 IR 4235; readopted filed Nov 27, 2007, 6:52 a.m.: 20071226-IR-465070551RFA; readopted filed November 26, 2013, 4:02 p.m.: 20131225-IR-465130459RFAReadopted filed 10/10/2019, 10:42 a.m.: 20191106-IR-465190320RFA 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.