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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.

provision because Medicaid is the primary source of public insurance for Part C services and Medicaid generally does not have limitations on lifetime coverage, pose any risk of increased premiums, or present any risk of loss of eligibility or discontinuation of benefits or insurance that would trigger the consent requirement. However, in those instances where there was a risk of increased premiums or out-of-pocket costs, States may create incentives for parents to provide consent by ensuring that

the State’s system of payments ensures that no out-of-

pocket costs (including premium costs) are incurred by those parents eligible for Medicaid (currently 133% of the Federal poverty level).

Finally, §303.520(a)(1) permits the State to access a

child’s or parent’s public benefits or insurance if the

State provides written notification to the child’s parents

and so long as the parent would not incur the specified costs identified above as a result of the use of those benefits, unless the parent had provided consent to use of such benefits for those services.

Section 303.520(a)(3) specifies that this written notification must include: (1) a statement that parental

consent must be obtained under §303.414 (where applicable)

before the public agency discloses, for billing purposes,