ICAMA Forms

Implementation of IDs (User Names) and Designees Begins

ICAMA members have received an outline of the process for assigning access to the ICAMA 700 series form.

The Designee/ID (user name) process:

  • The state designee information will be provided to the secretariat (who will be responsible for the IDs (user names) and passwords)
  • The state designee will provide the secretariat with a list of the IDs (user names) in the format selected by the state
  • The secretariat will send these IDs (user names) to BlueIron in an encrypted format
  • BlueIron will input the names into the ICAMA form access system
  • BlueIron will generate initial passwords for all submitted IDs (user names)
  • BlueIron will send the IDs (user names) and initial passwords to the secretariat in an encrypted format
  • BlueIron will provide directions on changing the initial passwords using a HIPAA compliant format
  • The secretariat will provide the list generated by BlueIron and password change instructions to the designated person in the state in the format requested by the state
  • The state designee will change the initial passwords
  • The state designee will keep a list of the IDs(user names) and final passwords
  • The state designee will distribute the IDs (user names) and final passwords to the appropriate individuals

States are asked to completed the Designee/ID (user name) form by April 17, 2013.

To read the ICAMA 700 Form memorandum click here.

If you have questions, did not receive the e-mail, or need a new Desination/ID form, please contact: Robyn Bockweg at: rbockweg@aphsa.org.

The day-to-day administration of the ICAMA is done by state professionals using the ICAMA forms.

ICAMA form 6.01 is the NOTICE OF MEDICAID ELIGIBILITY/CASE ACTIVATION which is sent to the ICAMA administrator in the new state.

*ICAMA form 7.02 is the NOTICE TO FAMILIES and is sent to the adoptive parents or guardians. Included with the ICAMA 7.02 are a copy of the ICAMA 6.01 (Notice of Medicaid Eligibility/Case Activation) that was sent to the new state and the 7.02b Important Information for Families.

ICAMA form 7.02b IMPORTANT INFORMATION FOR FAMILIES helps parents or guardians better understand the interstate process.

ICAMA form 6.03 is the REPORT OF CHANGE IN CHILD\FAMILY STATUS which is sent to the Adoptiion Assistance state and/or the new state of residence and the adoptive parents

*ICAMA form 7.02 is effective July 30, 2012.

 

 

 

Updated: May 30, 2013