Ohio Administrative Code
Title 5101:2 - Division of Social Services
Chapter 5101:2-47 - Title IV-E Foster Care Maintenance
Section 5101:2-47-05 - Title XIX medicaid coverage for Title IV-E foster care maintenance (FCM) recipients in accordance with the Consolidated Omnibus Budget Reconciliation Act (COBRA)
Universal Citation: OH Admin Code 5101:2-47-05
Current through all regulations passed and filed through September 16, 2024
(A) Children placed outside Ohio
(1) Within twenty business days after a Title
IV-E FCM eligible and reimbursable child's placement out of state, the Ohio
Title IV-E agency must take the following actions to transfer Title XIX
medicaid coverage to the Title XIX medicaid authority in the state where the
child has been placed:
(a) Provide written
notifications to the responsible Title XIX medicaid authority in the state in
which the child is placed of Ohio's intent to terminate the medicaid coverage.
Notification shall, at a minimum, include the following:
(i) The proposed effective termination date
of Ohio's Title XIX medicaid coverage.
(ii) A statement that the Title IV-E agency
will continue to receive FCM reimbursements on the child's behalf and the Title
XIX medicaid coverage will be provided by the state where the child is
placed.
(b) Request
written notification of the effective date of Title XIX medicaid coverage from
the Title IV-E agency in the state where the child is placed.
(c) Inform the custodial Title IV-E agency of
its right to a state hearing in accordance with Chapters 5101:6-1 to 5101:6-9
and rule
5101:6-3-01 of the
Administrative Code.
(d) Ensure the
Title XIX medicaid coverage in the Ohio statewide
automated child welfare information system (SACWIS) is terminated and the out
of state Title XIX medicaid coverage begins.
(2) Once every twelve months, provide the
responsible Title XIX medicaid authority in the state where the child is placed
with verification of the child continuing to be eligible for FCM
reimbursement.
(3) When the child
is no longer eligible for FCM reimbursement, provide written notification,
within twenty business days of the determination, to the Title XIX medicaid
authority in the state where the child is placed.
(B) Children placed in Ohio from another state
(1) Within twenty business days after
being notified by a custodial Title IV-E agency from the other state that a FCM
eligible and reimbursable child has been placed in Ohio, the following actions
must be taken in order to authorize Title XIX medicaid coverage:
(a) The Ohio Title IV-E agency must obtain
the following information, in writing, from the custodial Title IV-E agency in
another state:
(i) The child's name, social
security number and date of birth.
(ii) The substitute care provider's name and
address.
(iii) The address where
the medicaid card should be sent.
(iv) Verification of eligibility for FCM,
which may include an approved FCM application.
(v) The name, address and phone number of a
contact person at the custodial agency in another state with Title IV-E FCM
case management responsibility.
(vi) The date Title XIX medicaid coverage in
the state where the child is placed from will be terminated.
(vii) Any additional information regarding
other health insurance coverage the child may have, including third-party
liability.
(b) The Ohio
Title IV-E agency must enter the appropriate COBRA FCM information in
Ohio SACWIS which will authorize medicaid
coverage.
(c) The Ohio Title IV-E
agency must provide written notification of the effective date of Title XIX
medicaid coverage to the custodial Title IVE agency.
(d) The Ohio Title IV-E agency must complete
the ODM 06612 "Health Insurance Information Sheet" if there is information that the
child is covered under a health insurance plan.
(2) Once every twelve months, the Ohio Title
IV-E agency shall request verification of continuing FCM eligibility from the
custodial Title IV-E agency in the state receiving FCM reimbursements on behalf
of a child placed in Ohio. Upon notification from the custodial Title IV-E
agency that the child does not meet FCM program eligibility and reimbursability
criteria, the Ohio Title IVE agency shall take steps to:
(a) Terminate Title XIX medicaid coverage in
Ohio SACWIS and follow the procedures outlined in
Chapters 5101:6-1 to 5101:6-9 of the Administrative Code, in particular, rule
5101:6-3-01 of the
Administrative Code.
(b) Advise the
custodial Title IV-E agency that Ohio Title XIX medicaid coverage on behalf of
the child may be explored.
(C) The Title IV-E agency shall maintain a separate case record for each FCM recipient who is placed in Ohio by a custodial Title IV-E agency. At a minimum, the case record shall contain all of the information required in paragraph (B) of this rule.
(D) A child who is eligible for FCM reimbursement in Ohio shall not be denied Title XIX medicaid coverage if the other state does not make Title XIX medicaid coverage available.
Disclaimer: These regulations may not be the most recent version. Ohio may have more current or accurate information. We make no warranties or guarantees about the accuracy, completeness, or adequacy of the information contained on this site or the information linked to on the state site. Please check official sources.
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