5016           MEDICAL SUPPORT ASSIGNMENT AND COOPERATION WITH CHILD SUPPORT SERVICES DIVISION (CSSD Child Support Services Division)

5016 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 caretaker relatives 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:

• Establishing the paternity of each child in the household;
   

• Identifying and locating the child’s noncustodial parent; and
   

• Obtaining medical support for the child.

Except for the caretakers listed in Section B below, a parent or caretaker who is requesting or receiving Medicaid benefits for a child in their care is required to cooperate with CSSD. Cooperation with CSSD is waived if the caseworker determines the caretaker has good cause for not cooperating with CSSD.  If the caretaker does not cooperate and does not have good cause, the caretaker will be subject to a penalty under the Medicaid program.  The children will be included in the Medicaid case and CSSD will still pursue establishing paternity and enforcing a medical support order for the children receiving Medicaid benefits.

Option To Withdraw From Cash Support Enforcement For Medicaid-Only Cases:  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 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 noncustodial 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.

5016 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 (CSSD 1603a) or otherwise cooperate with CSSD:

1. A pregnant woman through the end of her postpartum period as defined in Section 5320;  

Note:

When the newborn is added to the case, the caretaker must be informed of the medical support requirements and a CSSD 1603a form may be required after the post-partum ends.

2. 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;
    

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

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

5. 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; or

In addition, completion of the Child Support Information form (CSSD 1603a) and other cooperation with CSSD is not required when:

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

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

• The dependent child’s noncustodial parent is deceased; or
   

• 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 these situations, the caseworker does not complete the Absent Parent Identification (APID) and related screens on EIS Eligibility Information System.  This prevents an unnecessary referral to CSSD Child Support Services Division.