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ICAMA Forms

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

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

Form 6.02 Form 6.02 is the NOTICE OF ACTION sent to the adoptive parents.

Form 6.03 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

Currently these forms are being reviewed by state representatives. Click here to see the work that is being done by the Forms Review Committee.