IDEA 2004: Building the Legacy
Part C (birth - 2 years old)
Note: This document has been delivered to the Office of the Federal Register but has not yet been scheduled for publication. The official version of this document is the document that is published in the Federal Register.
300.154(e) concerning accessing private insurance to pay for services under Part B of the Act; (4) is inconsistent with confidentiality protections under the Act and HIPAA and also with the Employee Retirement Income Security Act of 1974 (ERISA); and (5) could not be uniformly applied because not all private insurance policies are subject to State statutes.
Discussion: The purpose of the exception in §303.520(b)(2)
is to enable the lead agency in a State that has adopted specific statutory cost protections to use private insurance to pay for Part C services. In those States that have adopted such protections, private insurance funds are used to pay for Part C services (e.g., occupational or speech therapy) that are considered medically necessary for an infant or toddler with a disability. We have clarified
proposed §303.520(b)(2) to make clear that the exception to
parental consent applies only if the State’s statutory
protections expressly provide that for the protections
listed in new §303.520(b)(2)(i), (b)(2)(ii), and (b)(2)
The implementation of such State statutory protections is consistent with sections 632(4)(B) and 640 of the Act. Section 632(4)(B) of the Act requires early intervention services to be provided at no cost except where a State has