(1) A
child with special needs who resides in this state and is the
subject of an adoption assistance agreement with another state is
entitled to receive a medical assistance identification card from
this state upon the filing with the department of a certified
copy of the adoption assistance agreement obtained from the
adoption assistance state. In accordance with regulations of the
medical assistance administration, the adoptive parents are
required at least annually to show that the agreement is still in
force or has been renewed.
(2) The medical assistance administration shall consider the
holder of a medical assistance identification under this section
as any other holder of a medical assistance identification under
the laws of this state and shall process and make payment on
claims in the same manner and under the same conditions and
procedures as for other recipients of medical assistance.
(3) The medical assistance administration shall provide
coverage and benefits for a child who is in another state and is
covered by an adoption assistance agreement made by the
department for the coverage or benefits, if any, not provided by
the residence state. Adoptive parents acting for the child may
submit evidence of payment for services or benefit amounts not
payable in the residence state for reimbursement. No
reimbursement may be made 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 shall adopt rules implementing this subsection. The
additional coverage and benefit amounts provided under this
subsection must be for services to the cost of which there is no
federal contribution, or which, if federally aided, are not
provided by the residence state. The rules must include
procedures to be followed in obtaining prior approval for
services if required for the assistance.
(4) The submission of any claim for payment or reimbursement
for services or benefits under this section or the making of any
statement that the person knows or should know to be false,
misleading, or fraudulent is punishable as perjury under chapter 9A.72 RCW.
(5) This section applies only to medical assistance for
children under adoption assistance agreements from states that
have entered into a compact with this state under which the other
state provided medical assistance to children with special needs
under adoption assistance agreements made by this state. All
other children entitled to medical assistance under an adoption
assistance agreement entered into by this state are eligible to
receive assistance in accordance with the applicable laws and
procedures.
[1997 c 31 § 7. Formerly RCW 74.13.158.]