(a)A child with special needs resident in this
state who is the subject of an adoption assistance agreement with
another state shall be entitled to receive a medical assistance
identification from this state upon the filing in the local office for the
county in which the child resides of a certified copy of the adoption
assistance agreement obtained from the adoption assistance state. In
accordance with rules of the department, the adoptive parents shall be
required at least annually to show that the agreement is still in force or
has been renewed.
(b)The department shall consider the holder of a medical assistance
identification pursuant to this section as any other holder of a medical
assistance identification under the laws of this state and shall process
and make payment on claims on
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(a) A child with special needs resident in this
state who is the subject of an adoption assistance agreement with
another state shall be entitled to receive a medical assistance
identification from this state upon the filing in the local office for the
county in which the child resides of a certified copy of the adoption
assistance agreement obtained from the adoption assistance state. In
accordance with rules of the department, the adoptive parents shall be
required at least annually to show that the agreement is still in force or
has been renewed.
(b) The department shall consider the holder of a medical assistance
identification pursuant to this section as any other holder of a medical
assistance identification under the laws of this state and shall process
and make payment on claims on account of such holder in the same
manner and pursuant to the same conditions and procedures as for
other recipients of medical assistance.
(c) The department 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 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 department shall adopt rules 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, such rules shall
include procedures to be followed in obtaining prior approvals for
services in those instances where required for the assistance.
(d) A person who submits any claim for payment or reimbursement
for services or benefits pursuant to this section or makes any statement
in connection therewith, which claim or statement the maker knows or
should know to be false, misleading, or fraudulent commits a Level 6
felony.
(e) 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 to children with special needs
under adoption 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.
[Pre-1997 Recodification Citation: 31-3-5-5.]