199.5954 State medical assistance for special-needs adoptee.
516 words·~2 min read·
/ky/chapter-199/199-5954A research copy — for the controlling text, always check the official state or federal source. Not legal advice.
(1)A child with special needs residing in this state, who is the subject of an adoption
assistance agreement with another state, shall be entitled to receive medical
assistance from this state upon the filing in the Department for Community Based
Services, Cabinet for Health and Family Services, a certified copy of the adoption
assistance agreement obtained from the adoption assistance state. In accordance
with regulations of the Department for Medicaid Services, Cabinet for Health and
Family Services, the adoptive parents shall be required at least annually to show that
the agreement is still in force or has been renewed.
(2)The Department for Medicaid Services, Cabinet for Health and Family Services
shall consider recipients of medical assistance pursuant to this section as any other
recipient of medical assistance under the laws of this state and shall process and
make payment on claims on account of the recipient in the same manner and
pursuant to the same conditions and procedures as for other recipients of medical
assistance.
(3)The Department for Medicaid Services, Cabinet for Health and Family Services
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
Community Based Services, Cabinet for Health and Family Services, 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 Cabinet for Health and Family
Services shall make regulations 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, the regulations
shall include procedures to be followed in obtaining prior approvals for services in
those instances where required for the assistance.
(4)The submission of any claim for payment or reimbursement for services or benefits
pursuant to this section or the making of any statement in connection therewith,
which claim or statement the maker knows or should know to be false, misleading,
or fraudulent shall be punishable as perjury and shall also be subject to a fine not to
exceed ten thousand dollars ($10,000) or imprisonment for not more than two
years, or both such fine and imprisonment.
(5)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 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.