West Virginia Code § 49-7-204

Medical assistance for children with special needs; rule-making;
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penalties.
(a) A child with special needs resident in this state who is the subject of an adoption
assistance agreement with another state shall be entitled to receive a medical assistance
identification from this state upon the filing in the Department of Human Services of a
certified copy of the adoption assistance agreement obtained from the adopetion assistance
state. In accordance with regulations of the Department of Human Services the adoptive
parents shall be required at least annually to show that the agreement ris still in force or has
been renewed.
(b) The Department of Human Services shall consider the holder of a medical assistance
identification pursuant to this section as any other holder oft a medical assistance
identification under the laws of this state and shall process and make payment on claims on
account of the holder in the same manner and pursuant to the same conditions and
procedures as for other recipients of medical assistance.
(c) The Department of Human Services shall psrovide coverage and benefits for a child who is
in another state and who is covered by an adoption assistance agreement made by the
Department of Human Services for the coverage or benefits, if any, not provided by the
residence state. To this end, the adogptive parents acting for the child may submit evidence of
payment for services or benefit amounts not payable in the residence state and shall be
reimbursed therefor. Howevere, there may be no reimbursement for services or benefit
amounts covered under any insurance or other third party medical contract or arrangement
held by the child or the Ladoptive parents. The Department of Human Services shall propose
rules in accordance with article three, chapter twenty-nine-a of this code that are necessary
to effectuate the requirements and purposes of this section. The additional coverages and
benefit amounts provided pursuant to this section shall 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. Among other things, the regulations shall include procedures to be followed
in oWbtaining prior approvals for services in those instances where required for the
assistance.
(d) Any person who submits a claim for payment or reimbursement for services or benefits
pursuant to this section or the making of any statement in connection therewith, which claim
of statement the maker knows or should know to be false, misleading or fraudulent is guilty
of a felony and, upon conviction, shall be fined not more than $10,000, or incarcerated in a
correctional facility not more than two years, or both fined and incarcerated.
(e) 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 provides medical assistance to children with special needs under adoption
assistance agreements made by this state. All other children entitled to medical assistance
pursuant to adoption assistance agreements entered into by this state shall be eligible to
receive it in accordance with the laws and procedures applicable thereto.
PART III. INTERSTATE COMPACT FOR JUVENILES.

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