TITLE 53. SOCIAL SERVICES AND INSTITUTIONS

CHAPTER 4. CHILDREN'S SERVICES

Part 10. Children's Health Insurance

Department To Adopt Rules -- Review By Interim Committee

53-4-1009. (Temporary) Department to adopt rules -- review by interim committee. (1) The department of public health and human services shall adopt rules necessary for the administration of the program, including rules governing the application process, termination, and confidentiality.

(2) The rules may include, as necessary:

(a) the amount, scope, and duration of specific services provided;

(b) criteria to ensure that the services provided are medically necessary and cost-effective;

(c) provisions for participant cost sharing, including, at the department's discretion:

(i) the establishment of enrollment fees, premiums, deductibles, and copayments; and

(ii) the process for setting the amounts of enrollment fees, premiums, deductibles, and copayments, taking into account a participant's family income and resources; and

(d) the type of professionals who may deliver services or direct the delivery of services and the qualifications required of those professionals.

(3) In adopting rules, the department shall consider the federal requirements on which the receipt of the federal share of program funds are contingent and may not include any provision that places that funding at risk. Rules adopted by the department must, when appropriate, take into account the availability of appropriated funds.

(4) Rules adopted by the department pursuant to 53-4-1004 and 53-4-1009 must be presented to and reviewed by an appropriate interim committee that examines issues related to children and families. (Terminates on occurrence of contingency--sec. 15, Ch. 571, L. 1999.)

History: En. Sec. 8, Ch. 571, L. 1999; amd. Sec. 5, Ch. 476, L. 2001.