42-10-127. Medical benefits -- rules. (1) The provisions of this section apply only when the compact entered by this state and the other state under 42-10-121 through 42-10-128 provides that the adoption assistance state, whether it be this state or the other state, shall continue medical assistance to children in accordance with the adoption assistance agreements made by the adoption assistance state after the children have changed their residence to this state or to the other state. All other children entitled to medical assistance in this state are eligible to receive it in accordance with the applicable laws and procedures.

(2) A child with special needs residing in this state who is the subject of an adoption assistance agreement with another state is entitled to receive medical assistance identification from this state upon the filing in the office of the department of public health and human services located in the county of the child's residence a copy of the adoption assistance agreement. Medical assistance identification gained pursuant to this section entitles the holder to processing and payment on claims of the holder in the same manner and pursuant to the same conditions and procedures as other recipients of medical assistance.

(3) The department of public health and human services shall provide coverage and benefits for a child who is in another state who is covered by an adoption assistance agreement entered into in this state for coverage or benefits, if any, provided for under the adoption assistance agreement made in this state but not provided by the residence state. The adoptive parents acting for the child may submit evidence of payment for services or benefit amounts not payable in the residence state and must be reimbursed for the services. However, there may not be 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 of public health and human services shall adopt rules implementing this subsection. The additional coverage and benefit amounts provided by this subsection are for services for which there is no federal contribution or for which, if federally aided, contributions are not provided by the residence state. Rules adopted pursuant to this subsection must include procedures to be followed for obtaining prior approval for services covered by this subsection when prior approval is required.

History: En. Sec. 7, Ch. 274, L. 1991; amd. Sec. 347, Ch. 546, L. 1995; Sec. 52-2-527, MCA 1995; redes. 42-10-127 by Sec. 174, Ch. 480, L. 1997.