Sec 36-2995. Children's health insurance program fund; sources of monies; use; reversion; claims

A. The children's health insurance program fund is established. The administration shall administer the fund and shall use fund monies to pay administrative and program costs associated with the operation of the program established by this article.

B. Separate accounting shall be made for each source of monies received pursuant to subsection C of this section for expenses and income activity associated with the program established pursuant to this article.

C. Monies in the fund are comprised of:

1. Federal monies available to this state for the operation of the program.

2. Tobacco tax and state general fund monies appropriated as state matching monies.

3. Gifts, donations and grants from any source.

4. Interest paid on monies deposited in the fund.

5. Third party liability recoveries.

D. If a gift, a donation or a grant of over ten thousand dollars received from any private source contains a condition, the administration shall first meet with the joint legislative study committee on the integration of health care services to review the condition before it spends that gift, donation or grant.

E. All monies in the fund other than monies appropriated by this state do not lapse.

F. Monies appropriated from the medically needy account of the tobacco tax and health care fund are exempt from section 35-190 relating to lapsing of appropriations. Notwithstanding section 35-191, subsection B, the period for administrative adjustments extends for only six months for appropriations made for administration covered services.

G. Notwithstanding sections 35-190 and 35-191, all approved claims for system covered services presented after the end of the fiscal year in which they were incurred shall be paid either in accordance with this section or in the current fiscal year with the monies available in the funds established by this section.

H. Claims for covered services that are determined to be valid by the director and the grievance and appeal procedure shall be paid from the children's health insurance program fund.

I. All payments for claims from the children's health insurance program fund shall be accounted for by the administration by the fiscal year in which the claims were incurred, regardless of the fiscal year in which the payments were made.

J. Notwithstanding any other law, county owned or contracted providers and special health care district owned or contracted providers are subject to all claims processing and payment requirements or limitations of this chapter that are applicable to noncounty providers.