The Interstate Compact on Adoption and Medical Assistance

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The Interstate Compact on Adoption and Medical Assistance (ICAMA) is a compact between 49 states, the District of Columbia and Puerto Rico. New York became an Associate Member of this compact in 2006.

ICAMA is the mechanism used to coordinate health care in interstate adoption cases. Interstate cooperation is essential in light of the ever-increasing numbers of children placed for adoption across state lines and for families with adopted children relocating outside of the state from which they receive Title IV-E Adoption Assistance or, in many cases, non-Title IV-E adoption subsidy.

An ICAMA request notifies the receiving state that a child in receipt of Adoption Assistance or adoption subsidy is moving into their state. The request provides the required documentation for the receiving state to authorize the child’s eligibility for Medicaid based on the child’s receipt of adoption subsidy. If the child is eligible for Medicaid, the receiving state will begin the process of opening Medicaid for that child. Medicaid programs differ in each state. The scope of Medicaid benefits for which the adopted child will remain eligible is contingent upon the scope of the Medicaid provisions in the receiving state.

Information for Adoptive Parents Moving Across State Lines

If your child is in receipt of a New York State adoption subsidy and you plan to move out of state you should take the following step:

Lists of LDSS contacts can be found at

It is the responsibility of the adoptive parent to provide the LDSS with a copy of the approved adoption subsidy agreement, the child’s current name, child’s valid Social Security number, child’s race and ethnicity, adoptive parent’s race and ethnicity, current address, current phone number and email address, the address in the new state of residence, a valid phone number and email address for the new residence, and the date the Medicaid needs to be opened in the new state of residence.

If your child is in receipt of adoption subsidy from outside of New York State and you plan to move into New York State you should take the following step:

Information for NYS Caseworkers

Specific documents must be included in each ICAMA request. Administrative Directive 22-OCFS-ADM-19 issued by the Office of Children and Family Services (OCFS) provides information on the process.

The forms used for ICAMA are:

The ICAMA forms can be found on the AAICAMA website at or by emailing the OCFS Bureau of Permanency Services (BPS).

All ICAMA requests must be completed and submitted electronically. Caseworkers must submit ICAMA packets to the OCFS BPS shared email at: or FAX ICAMA requests to

If you have questions, feel free to contact the New York State ICAMA Compact Administrator at

For additional ICAMA information, including frequently asked questions, state contact information and the full Compact text, go to the AAICAMA Home Page.