5101:2-44-05.2 Covered families and children (CFC) medicaid eligibility for state adoption subsidy recipient moving from or to Ohio.

(A) Residence in Ohio is a requirement for covered families and children (CFC) medicaid as outlined in paragraph (C)(2) of rule 5160:1-2- 01.8 of the Administrative Code. An adoptive child with special needs who is in receipt of an Ohio-executed state adoption subsidy and who does not live in Ohio is not eligible for Ohio CFC medicaid even if the subsidy payment continues.

(B) An adoptive child described in paragraph (A) of this rule may be eligible for medicaid in the new residence state, as outlined in paragraph (C)(2) of rule 5160:1-2- 01.8 of the Administrative code, if one of the following applies:

(1) The new residence state has elected, in its state medicaid plan, the state option for its state adoption subsidy children.

(2) The new residence state and the Ohio department of job and family services (ODJFS) are parties to an interstate agreement for reciprocal medicaid coverage of state adoption subsidy children.

(3) The new residence state elects in its state medicaid plan to reciprocate with all states for medicaid coverage of state adoption subsidy children, whether or not the states are parties to an interstate agreement.

(C) If a child moves from Ohio into a new residence state, the Ohio public children services agency (PCSA) which entered into the JFS 01615 "State Adoption Maintenance Subsidy Agreement" (rev. 4/2014) shall:

(1) Within seven business days after notification of the child's relocation or intent to relocate to another state, complete and forward the original interstate compact on adoption and medical assistance (ICAMA) form 6.01 "Notice of Medicaid Eligibility/Case Activation," appendix A to this rule, ICAMA form 7.02 "Notice to Families," appendix B and 7.02 b "Important Information for Families," appendix D to this rule, and a copy of the current signed and dated JFS 01615 to the ODJFS ICAMA state administrator.

(2) Upon notification of an additional change in the child's or family's status, the PCSA shall, within seven business days, complete and forward the ICAMA form 6.03 "Report of Change in Child/Family Status," appendix C to this rule, to the ODJFS ICAMA state administrator.

(3) Annually, the PCSA shall provide the ODJFS ICAMA state administrator with evidence that the JFS 01615 is still in effect, has been renewed, or has been modified.

(D) If an adoptive child moves from Ohio to another state:

(1) The adoptive parent shall inform the PCSA of the family's address and telephone number within ten days of relocation.

(2) The PCSA that supervises the original JFS 01615 shall notify the adoptive parent that Ohio medicaid coverage will be terminated.

(3) The PCSA shall notify the county department of job and family services (CDJFS) that the Ohio medicaid case shall be closed.

(E) An adoptive child with special needs who is a resident of Ohio and in receipt of a state adoption subsidy agreement from another state is eligible to receive Ohio CFC medicaid, as outlined in paragraph (C)(2) of rule 5160:1-2- 01.8 of the Administrative Code, if:

(1) The state which entered into the state adoption subsidy agreement has been identified as a member of ICAMA.

(2) The state is not identified as a member of ICAMA but has elected in its state medicaid plan to provide medicaid coverage for its own state adoption subsidy children.

(3) The state which entered into the state adoption subsidy agreement and ODJFS are parties to an interstate agreement for reciprocal medicaid coverage of state adoption subsidy children.

(F) If an adoptive child moves from another state to Ohio and has a state adoption subsidy agreement in effect with another state, the CDJFS shall:

(1) Upon receipt of the ICAMA form 6.01, the state adoption subsidy agreement, and a completed JFS 07216 "Combined Programs Application" (rev. 11/2013) from the adoptive parent(s), determine the child's eligibility for CFC medicaid as outlined in paragraph (C)(2) of rule 5160:1-2- 01.8 of the Administrative Code.

(2) After determination of medicaid eligibility, complete and forward to the ODJFS ICAMA state administrator the original ICAMA form 6.03.

(3) Upon notification of additional changes in the child's or family's status, the CDJFS shall, within seven business days, complete and forward the original form 6.03 to the ODJFS ICAMA state administrator.

(G) The CDJFS shall be responsible for administration of any ICAMA applications received or distributed at the county level.

(H) Copies of all ICAMA forms and correspondence shall be maintained in the child's state adoption subsidy case record.

(I) The adoptive parents, whether moving from or to Ohio, shall provide the residence state with any information regarding medical assistance or insurance available to the child.

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Effective: 06/12/2014
R.C. 119.032 review dates: 03/12/2014 and 06/01/2019
Promulgated Under: 119.03
Statutory Authority: 5153.163
Rule Amplifies: 5153.16 , 5153.163
Prior Effective Dates: 1/1/92 (Emer.), 3/20/92, 5/1/03, 7/1/04, 5/1/09