Ohio Administrative Code
Title 5101:2 - Division of Social Services
Chapter 5101:2-49 - IV-E Adoption Assistance
Section 5101:2-49-19 - Title XIX medicaid coverage for Title IV-E adoption assistance (AA) eligible children (COBRA)
Universal Citation: OH Admin Code 5101:2-49-19
Current through all regulations passed and filed through December 16, 2024
(A) A child eligible for AA, is eligible for Title XIX medicaid coverage beginning with the effective date of the JFS 01453 "Title IV-E Adoption Assistance Agreement."
(B) The public children services agency (PCSA) is to inform the adoptive parent(s) that he or she is to notify the PCSA within fifteen calendar days after moving to another county or state.
(C) The parent(s) is to cooperate with the PCSA to assure that a move out-of-state complies with any applicable interstate requirements. Failure to notify the PCSA may result in the interruption of Title XIX medical coverage.
(D) For a child with an AA agreement in effect who moves or resides out-of-state, the following is to apply:
(1) Within seven business days after
the PCSA is notified by the adoptive parent(s) that the AA eligible child is
moving to or residing in another state, the PCSA is to transfer
Title XIX medical coverage to the state of residence by:
(a) Completing and forwarding the current
signed and dated JFS 01453 to the Ohio department of job and family services
(ODJFS) interstate compact on adoption and medical assistance (ICAMA) state
administrator pursuant to rule
5101:2-44-05.2 of the
Administrative Code.
(b) Providing
written notification to the adoptive parent(s) of Ohio's intent to terminate
the Title XIX medical coverage. Notification is to, at a
minimum, include all of the following:
(i) The
effective termination date of Ohio's Title XIX medical coverage.
(ii) A completed JFS 04065 "Prior Notice of
Right To A State Hearing."
(iii) A statement that the child will
continue to receive AA payments from Ohio or, if no payments are being made, a
statement that the JFS 01453 remains in effect and Title XIX medical coverage
will be provided by the state in which the child resides.
(c) Terminating the medical coverage in the
Ohio statewide automated child welfare
information system (SACWIS).
(2) Upon notification of any change that
would affect the medicaid status, the PCSA is to, within
seven business days, complete and forward the ICAMA form 7.5 "Information
Exchange" which can be found
at:
https://aaicama.org/cms/index.php/the-aaicama/new-icama-forms/icama-forms
to the ODJFS ICAMA state administrator.
(3) No less than annually, the PCSA
is to
provide the responsible Title XIX medical authority in the state where the
child resides with written verification that the child meets the continuing
eligibility requirements for medicaid. If the PCSA determines the child does
not meet the continuing eligibility requirements, within twenty business days
the PCSA is
to:
(a) Complete a medicaid
pre-termination review (PTR) of continuing medicaid eligibility pursuant to
rule 5160:1-2-01 of the
Administrative Code.
(b) Provide
written notification of the date Title XIX medical coverage
is to be
terminated to the responsible Title XIX medical authority in the state in which
the AA eligible child resides.
(E) For a child with an out-of-state AA agreement in effect who moves to or resides in Ohio, the following is to apply:
(1) The child is automatically eligible
for Title XIX medical coverage provided by Ohio.
(2) The PCSA is to, within
twenty business days after being notified by the ODJFS ICAMA administrator take
the following actions to activate Title XIX medical coverage:
(a) Verify the following information is
included on the ICAMA form
7.01 received from the
responsible Title XIX authority and the national ICAMA database:
(i) The child's name, social security number,
date of birth, and address.
(ii)
The name of adoptive parent(s).
(iii) The address where the medical card
should be sent.
(iv) A copy of the
sending state's AA agreement.
(v)
The name, address and telephone number of a contact person in the state with
Title IV-E case management responsibility.
(vi) The termination date of Title XIX
medical coverage in the state with Title IV-E case management responsibility or
the state where the child moved.
(vii) Any additional information regarding
other health insurance coverage the child may have, including third-party
liability.
(b) Enter
into Ohio SACWIS the Ohio medicaid effective date
and an "active" status on the ICAMA record.
(c) Complete the ODM 06612 "Health Insurance
Information Sheet" if there
is information that the child is covered by a private health insurance
plan.
(3) The PCSA
is to
maintain a separate case record for each AA eligible child who resides in Ohio.
The case record is to contain all of the information required in
paragraph (D) of this rule for all children with AA agreements in effect who
move to or reside in Ohio.
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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