812           MEDICAL SUPPORT ASSIGNMENT AND COOPERATION WITH CHILD SUPPORT SERVICES DIVISION (CSSD)

812 A.      PURPOSE

Medical support from any noncustodial parent (also referred to as the absent parent) who has health insurance available is essential to helping most families to become self-supporting and keeping the children healthy. Because of this, Medicaid rules require parents or guardians who can legally assign rights to medical support for a child in their care and is requesting Medicaid benefits for that child to assign their rights to any medical support from all sources to the state while they are receiving Medicaid, and to cooperate with the Child Support Services Division (CSSD) in:

1.  Establishing the paternity of each child in the household;

2.  Identifying and locating the child’s noncustodial parent; and

3.  Obtaining medical support for the child.

Generally, any individual age 18 or older who is a parent or guardian and who can legally assign rights to medical support for a child in their care and who is requesting or receiving Medicaid benefits for that child is required to cooperate with CSSDChild Support Services Division. This includes an adult who is an APAAdult Public Assistance related or a MAGIModified Adjusted Gross Income Medicaid recipient applying for Medicaid on behalf of the adult's own child or a child for who the adult is the specified relative.

Except for the individuals listed in section 812 B, a parent or guardian who is requesting or receiving Medicaid benefits for a child in their care is required to cooperate with CSSDChild Support Services Division. Cooperation with CSSDChild Support Services Division is waived if the ETEligibility Technician determines the specified relative has good cause for not cooperating with CSSDChild Support Services Division.

If the parent or guardian does not cooperate and does not have good cause or meet an exemption under section 812 B, the parent or guardian will be subject to a penalty under the Medicaid program. The children will be included in the Medicaid case and CSSDChild Support Services Division will still pursue establishing paternity and enforcing a medical support order for the children receiving Medicaid benefits.

812 B.      WHO IS NOT REQUIRED TO COOPERATE

For the purpose of Medicaid eligibility, the following individuals are not required to complete the Child Support Information form or otherwise cooperate with CSSDChild Support Services Division:

1. A pregnant woman through the end of her postpartum period as defined in section 816-1 (B). This includes cooperation for all children in the pregnant mother's household; not just the unborn child.

Note:

When the newborn is added to the case and the mother's 12 months postpartum period has ended, the mother must be informed of the medical support requirements and that a Child Support Information form may be required.

2. An applicant who is under the age of 18 who is applying on behalf of his or her own child;

3. An applicant who is applying on behalf of a child who is a beneficiary of Indian Health Service (IHSIndian Health Service) funded Native health services and those services are reasonably available. In Alaska, IHSIndian Health Service services are reasonably available to almost all IHSIndian Health Service beneficiaries;

4. A custodial parent who is applying on behalf of a child who is already covered under either the custodial or noncustodial parent’s third-party health insurance. This health insurance must be for comprehensive major medical coverage.

Note:

Enrollment of a child in Medicaid does not satisfy the noncustodial parent’s obligation for providing medical support. If that occurs, the noncustodial parent will be required to repay the state for the cost of services provided to the child covered by Medicaid if those services should have been provided under the medical support order (i.e., dependent care coverage under the noncustodial parent’s health insurance).

5. Step-parents unless they are the only caretaker in the home.

6. A caretaker of a child in the household that is not eligible for the Parent/Caretaker category as the caretaker is not within 5th degree of kinship.

In addition, completion of the Child Support Information form and other cooperation with CSSDChild Support Services Division are not required when:

7. Both of the dependent child’s natural or adoptive parents are living in the home;

8. There is no other parent because the caretaker legally adopted the dependent child as a single parent;

9. The dependent child’s noncustodial parent is deceased; or

10. A child is in the protective custody of the Office of Children’s Services (OCS). OCSOffice of Children's Services cooperates directly with CSSDChild Support Services Division for children in state custody.

In these situations, the ETEligibility Technician does not complete the information about the noncustodial parent(s) in the eligibility system.