§8-60-13 - Students with disabilities who are covered by public benefits or insurance.

§8-60-13 Students with disabilities who are covered by public benefits or insurance. (a) Students with disabilities who are covered by public benefits or insurance.

(1) The department may use the medicaid or other public benefits or insurance programs in which a student participates to provide or pay for services required, as permitted under the public benefits or insurance program, except as provided in paragraph (2).

(2) With regard to services required to provide a FAPE to an eligible student, the department:

(A) May not require parents to sign up for or enroll in public benefits or insurance programs in order for their student to receive a FAPE under Part B of the Act;

(B) May not require parents to incur an out-of-pocket expense such as the payment of a deductible or co-pay amount incurred in filing a claim for services provided pursuant to this chapter, but the department may pay the cost that the parents otherwise would be required to pay;

(C) May not use a student's benefits under a public benefits or insurance program if that use would:

(i) Decrease available lifetime coverage or any other insured benefit;

(ii) Result in the family paying for services that would otherwise be covered by the public benefits or insurance program and that are required for the student outside of the time the student is in school;

(iii) Increase premiums or lead to the discontinuation of benefits or insurance; or

(iv) Risk loss of eligibility for home and community-based waivers, based on aggregate health-related expenditures; and

(D) (i) Shall obtain parental

consent, consistent with section 8-60-2, each time that access to public benefits or insurance is sought; and

(ii) Notify parents that the parents' refusal to allow access to their public benefits or insurance does not relieve the department of its responsibility to ensure that all required services are provided at no cost to the parents.

(b) Students with disabilities who are covered by private insurance.

(1) With regard to services required to provide a FAPE to an eligible student, the department, may access the parents' private insurance proceeds only if the parents provide consent consistent with section 8-60-2.

(2) Each time the department proposes to access the parents' private insurance proceeds, the department shall:

(A) Obtain parental consent in accordance with paragraph (1); and

(B) Inform the parents that their refusal to permit the department to access their private insurance does not relieve the department of its responsibility to ensure that all required services are provided at no cost to the parents.

[Eff 11/23/09] (Auth: 20 U.S.C. 1412(a)(12) and (e); HRS §302A-1112) (Imp: 34 C.F.R. §300.154)

 

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