Attachment B:  Interstate Medicaid Guidelines

This attachment provides guidelines for Interstate Medicaid through ICPC or ICAMA.

Interstate Compact on the Placement of Children (ICPC)

Missouri As The Sending State

The Eligibility Specialist must make a determination whether the child is/is not IV-E eligible.  The child must be determined to be eligible for Title IV-E in order to qualify for Medicaid outside of Missouri.

In order for the placement resource to be federally reimbursable, the child must be IV-E eligible, and the placement resource must:

1. Meet the receiving state’s home study standards, and
2. Receive a maintenance payment by the Children’s Division.

If a child is non IV-E eligible, Medicaid is not received automatically.  The placement resource can apply for Medicaid through public assistance, such as Temporary Assistance for Needy Families (TANF).  If the child does not qualify for Medicaid, the sending state is responsible for the child’s medical expenses.

Missouri as the Receiving State

To determine whether a child will be eligible for Medicaid, the following proper documentation is necessary:

1. The child must be determined to be IV-E eligible;
2. The resource provider has been licensed by the Children’s Division; and
3. The resource provider is receiving a maintenance payment on behalf of the child from the sending state.

If the child is non IV-E eligible, the placement resource will be directed to the Family Support Division (FSD) to apply for MO HealthNet.  If they do not qualify, the sending agency must be notified that they will be financially responsible for the child’s medical needs.

Interstate Compact on Adoption and Medical Assistance (ICAMA)

• Reciprocity provision:  A child is eligible for federal Medicaid coverage nationwide based upon the child’s receipt of Adoption Subsidy through a state which is a member of the Interstate Compact on Adoption and Medical Assistance (ICAMA);
• When a family plans to move away from the state which granted the Adoption Subsidy Agreement, the child’s Adoption Subsidy worker in that state should be notified by the parents regarding the moving date;
• The Adoption Subsidy worker should inform the family that Medicaid through ICAMA will be handled by the worker and the ICAMA Coordinators in the sending and receiving states.  Families should not contact the local family support office in the state to which they are moving, as this office is not able to open Medicaid coverage thru ICAMA;
• The Adoption Subsidy worker then contacts his/her ICAMA Coordinator in the worker’s state in order to initiate the process of continuing Medicaid coverage in the planned state of residence.  The ICAMA Coordinator will work with the adoption subsidy worker to gather required information and update the Alternative Care Client form, SS-61, for the child;
  
• The ICAMA Coordinators from the current state of residence and the planned state of residence will exchange required information in order to complete the Medicaid transfer between states;
• The state which carries the subsidy agreement with the family is always the responsible state for the ICAMA information-sharing throughout the length of the subsidy (no matter how many times the family moves, the original subsidy state shares information with the most current state of residence);
• The state which carries the adoption subsidy agreement will always be responsible for payment of the maintenance to the family, and the state of residence will be the state which is responsible for Medicaid coverage.

If there are questions or concerns throughout this process, please contact your ICAMA Coordinator in Central Office.