511 CHILD SUPPORT COOPERATION
An APA-related Medicaid applicant or recipient may apply for Medicaid on behalf of a child. Most adults applying for Medicaid on behalf of a child must cooperate with the Child Support Services Division ( CSSD ) and their effort to secure medical support for the child. Cooperation in child support services activities means the individual helps CSSD :
Establish the
paternity of each child for whom the individual can legally assign
rights;
Identify and
locate the absent parent of each child included in the household;
and
Obtain medical support or medical support payments for each child in the household.
CSSD is required by federal law to obtain a court or administrative order for medical support from any absent (or "obligor") parent who has available health insurance or other financial resources. An obligor parent may not satisfy this requirement by enrolling the child in Medicaid category. The obligor parent is required to repay the state for the cost Medicaid provided to the child that should have been provided under the medical support order (e.g., dependent care coverage under the obligor parent’s health insurance).
511 A. WHO IS REQUIRED TO COOPERATE
Generally, any individual age 18 or older who is a parent or who can legally assign rights to medical support for a child in their care and who is requesting or receiving Medicaid or Denali KidCare benefits for that child is required to cooperate with the CSSD . This includes an adult who is an APA-related Medicaid recipient applying for Medicaid on behalf of the adult’s own child or a child for whom the adult is the specified relative.
511 B. WHO IS NOT REQUIRED TO COOPERATE
For the purpose of determining Medicaid eligibility, the following individuals are not required to complete the CSSD 1603 or otherwise cooperate with CSSD :
A pregnant woman
through the end of her 60-day postpartum period;
An applicant
who is under the age of 21 and is applying for medical assistance
only for him or herself, regardless of the applicant’s living arrangement;
An applicant
who is under the age of 18 who is applying on behalf of his or her
own child;
An applicant
who is applying on behalf of a child who is a beneficiary of Indian
Health Service (IHS)
funded Native health services and those services are reasonably available.
In Alaska, IHS
services are reasonably available to almost all IHS beneficiaries;
A custodial
parent who is applying on behalf of a child who is already covered
under either the custodial or non-custodial parent’s third-party health
insurance; or
A specified relative who cannot legally assign rights to benefits for a child in their care for whom they are applying;
Cooperation is also not required in the following circumstances where, for practical purposes, there is no ”absent parent”:
Either natural
or adoptive parents are living in the home;
In a single-parent
adoption case and the adoptive parent is living in the home;
When the absent
parent is deceased; or
When a child is in the protective custody of the Office of Children’s Services (OCS). OCS cooperates directly with CSSD for children in state custody.
In the event of these circumstances, the caseworker should not complete the Absent Parent Identification (APID) and related screens on EIS . This prevents an unnecessary referral to CSSD .
511 C. HOW AN INDIVIDUAL COOPERATES WITH CSSD
An individual cooperates with CSSD by:
Completing and
signing the CSSD
1603, ”Child Support Information” form;
Appearing at
a CSSD office to
provide information or evidence relevant to the case;
Appearing as
a witness in a court or other proceeding;
Providing information
or attesting to lack of information under penalty of perjury or unsworn
falsification;
Paying to the
state any medical support payments received that are covered by the
assignment of rights; and
Taking any other reasonable steps to assist in establishing paternity and securing medical support and payments.
511 D. WITHDRAWAL FROM CASH SUPPORT ENFORCEMENT
An applicant or recipient of a Medicaid-only case may elect to withdraw from cash support enforcement. CSSD will not pursue cash support enforcement if the applicant or recipient has checked the ”no” box on Page 3 of the CSSD 1603a form indicating that they do not want to pursue cash support. In this situation, CSSD will pursue a medical support order only.
CSSD will establish a cash support order on Medicaid-only cases, unless the applicant or recipient elects to withdraw from cash support enforcement. Once a cash support order is established, the absent parent’s legal obligation to support his or her child begins. The cash support order will identify the amount of cash support the child is due.
511 E. PENALTY FOR FAILURE TO COOPERATE
An individual who is required to cooperate with CSSD , but who fails to do so without good cause, is ineligible for Medicaid. To stop Medicaid benefits from going out on an APA case, the eligibility worker will code the ineligible Medicaid individual ”OU” on the SEPA screen and then authorize the APA benefits. The eligibility worker will then initialize the case into the next month. The Medicaid issuance job will not issue the Medicaid benefit and EIS will not allow a field issuance. Should that individual want Medicaid benefits in the future, cooperation is required.
An APA-related Medicaid case of a non cooperating parent must be denied, or closed with adverse action.
Exception:
An SSI recipient will
remain Medicaid eligible. Once the SSI
ends, the eligibility worker will take action to close the stand-alone
Medicaid case.
Refer to MAGI MS 812 for more information about child support cooperation and good cause claims.
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