Chapter 5 : Section 38

Medical Services for ICPC Children

Policy

The Department will follow all rules and procedures required by the Interstate Compact on the Placement of Children (ICPC) in order to protect the interest of children in out-of-home care who move across state lines.

When an Arizona child is being placed in another state through the ICPC:

The Department shall provide Mercy Care DCS CHP’s medical coverage for children in out-of-home care who are ineligible for Title IV-E in the receiving state.

The Department’s Eligibility Unit shall review and re-determine the child’s Title IV-E eligibility every 12 months for Arizona children in out-of-home care who are placed out of state through ICPC.

The Department, through Mercy Care DCS CHP, shall review and consider payment for services that are not covered in the receiving state’s Medicaid program.

When a child from another state is placed in Arizona through the ICPC:

The DCS Eligibility Unit is responsible for verification of Title XIX eligibility, transmitting initial eligibility information to the Arizona Health Care Cost Containment System (AHCCCS), and transmitting eligibility re-determination information to AHCCCS every 12 months.

Procedures

When an Arizona child is being placed in another state through the ICPC

When placing an Arizona child in out-of-home care in another state through ICPC, the DCS Specialist will coordinate medical coverage in the receiving state.

Notify Mercy Care DCS CHP (CHPICPC@mercycareaz.org) upon referral to ICPC and include:
- the placement type (unlicensed kinship, licensed foster home, or in-patient behavioral health facility); and
- any known arrangements for medical, dental, or behavioral health services (especially if a child requires special appointments, equipment, supplies, or special arrangements for transition services).

Contact the Mercy Care DCS CHP Care Manager for assistance establishing health care in the state the child will be residing.
Encourage the ICPC Placement (unlicensed kinship homes and licensed foster homes) to begin the process to apply for Medicaid in the receiving state one week prior to placement. If unable to apply for Medicaid in the receiving state prior to placement, ensure the ICPC Placement applies for Medicaid within one week of the child’s placement.

Verify Title IV-E Eligibility by reviewing the Eligibility IV-E tab in Guardian (Title IV-E) prior to placing a child in another state.

Fill all prescribed medications prior to placing a child in another state. Attempt to obtain two to three months of medication(s) for the child to take to the receiving state in case of any delays (such as delays in Medicaid eligibility determination in the receiving state or in identifying an out-of-state pharmacy). Contact Mercy Care DCS CHP Member Services about any difficulties with obtaining prescribed medication.

Notify Mercy Care DCS CHP Title XIX Eligibility Unit (CHPTXIXEligibility@azdcs.gov) when the child has been placed in another state. This action will allow Mercy Care DCS CHP to end medical coverage in Arizona and may prevent a delay during the application process in the receiving state.

At the time of placing the child with the out-of-home caregiver, the DCS Specialist will provide the out-of-home caregiver with a list of all of the child’s medical and behavioral health:

services the child was receiving in Arizona (include the service provider’s name, phone number, and address); and

medications the child has been prescribed.

Timely applying for Medicaid or other type of insurance in another state will help avoid gaps in service. Contact Mercy Care DCS CHP Member Services if the child is in need of medical, dental, or behavioral services during any gaps in coverage.

Children in out-of-home care moving to a residential treatment facility in another state will continue with their health plan coverage under Mercy Care DCS CHP and AHCCCS.

Children in Out-of-home Care Who May Qualify for Medicaid or Other Medical Insurance in Receiving State

The DCS Specialist will assist the ICPC Placement (unlicensed kinship placement or licensed foster home) as needed to schedule an appointment with the receiving state’s Medicaid office and complete the application.

The DCS Specialist will assist the ICPC Placement as needed for the child in out-of-home care to obtain other Medical Insurance in the receiving state.

Children without Medical Insurance in Receiving State

Children in out-of-home care may not qualify for Medicaid or other medical insurance in the receiving state. The DCS Specialist will:

notify Mercy Care DCS CHP that the child is not eligible for Medicaid in the receiving state by requesting a denial letter from the receiving state and, upon receipt, email to Mercy Care DCS CHP at CHPResourceLiaison@azdcs.gov ;
ensure the ICPC Placement identifies service providers who are willing to become out-of-state providers for Mercy Care DCS CHP; and
complete and submit to Mercy Care DCS CHP the Health Provider Information form (provided by Mercy Care DCS CHP).

Mercy Care DCS CHP will contact the providers listed on the Health Provider Information form to discuss the AHCCCS registration process. NOTE: Mercy Care DCS CHP cannot pay for any medical/dental/specialized/behavioral health services until the provider is registered with AHCCCS. If the provider does not register with AHCCCS, payments must be coordinated through non-contracted claims.

DCS Specialist will:

discuss with parent, guardian, or custodian, if applicable, their willingness or ability to pay for services or inquire about other insurance options available;
send payment request to the appropriate Service Referral email , if no other payment source is available. Include the following with the payment request:
- court order, if applicable,
- efforts made by Mercy Care DCS CHP regarding payment,
- Arizona Substitute W-9 from the non-contracted provider,
- invoice, and
- any other supporting documentation available.

Special Circumstances

If the receiving state does not pay for a service that is normally covered by Mercy Care DCS CHP, refer the service provider or ICPC placement to Mercy Care DCS CHP for review and consideration. Prior authorization must be obtained prior to delivery of service.