Family and Children's Medicaid MA-3365 CHILD SUPPORT
II. REQUIREMENTS FOR making REFERRals TO THE CHILD SUPPORT ENFORCEMENT AGENCY
A. Evaluate and refer all Medicaid cases, including MAD, to Child Support Enforcement when one of the statements in 1, 2 or 3 is true and the conditions in 4 are met. See II.B. for exceptions.
1. The caretaker applies for Medicaid for himself and a child(ren).
2. The caretaker applies for himself and a child(ren) has ongoing coverage.
3. The caretaker is not applying for or receiving Medicaid but applies for a child(ren) only, requests services through Child Support Enforcement, and agrees to cooperate.
4. The child(ren) meets the following conditions:
a. The child(ren) is under age 18, or
b. The child(ren) is 18 through 20 years of age and
(1) Child support was established before age 18 and
(2) The child(ren) is attending primary or secondary school.
c. The child(ren) has at least one absent parent who is not deceased.
d. The child(ren) does not have health insurance or medical support payments.
(1) Even if the child(ren) has health insurance, if the caretaker requests services through Child Support, make the IV-D referral.
REVISED EFFECTIVE 04/01/10 – CHANGE NO. 04-10
(2) When the health insurance or medical support is lost, make the IV-D referral.
B. Do Not Make the Referral to Child Support in the Following Situations:
1. Good Cause is established (See IV.)
2. The application for the child(ren) is for retroactive coverage only or it is known in advance that it will be an open and shut application.
3. The child(ren) is living independent of a parent/caretaker. However, if requested, Child Support Enforcement could establish a medical support obligation for a minor child living independently from a caretaker, if that child has not been legally emancipated.
4. The child(ren) is an SSI recipient. The referral can be made if the caretaker requests IV-D assistance and agrees to cooperate.
5. During the mother’s post-partum period when the child(ren) receives Automatic newborn coverage. Do not send a referral to Child Support Enforcement for a child authorized for automatic newborn coverage until the end of the mother’s 60 day postpartum period unless the mother agrees to cooperate with Child Support Enforcement and requests that referral be made earlier.
6. The child(ren) or caretaker is receiving Expanded Foster Care Program Medicaid (EFCP). See II.C.2.
7. The caretaker is pregnant.
a. Any program category
Do not require a pregnant woman receiving Medicaid under any category to cooperate with IV-D in establishing paternity and obtaining medical support or medical support payments for the unborn child through the end of the postpartum period.
Do not require a pregnant woman receiving Medicaid under the MPW category to cooperate with IV-D in establishing paternity and medical support or medical support payments for any other children receiving Medicaid or Work First for whom she is the caretaker. At the end of the postpartum period, provided that one or both of the newborn child’s parents is absent from the home, evaluate and refer to Child Support, if appropriate. The woman must cooperate with IV-D to continue receiving Medicaid for herself. Inform the pregnant a/r of this requirement. Medicaid for the children is unaffected by this requirement.
REVISED EFFECTIVE 04/01/10 – CHANGE NO. 04-10
C. Foster Care
1. If appropriate (see II.B.6.), refer a child for whom an application has been made for I-AS (Title IV-E Foster Care) or H-SF (Non-Title IV-E Foster Care) after receiving form DSS-5120 (Eligibility Documentation/Verification for Foster Care Assistance and/or Medical Assistance) from the social worker.
a. The revised DSS-5120 contains a section in which the foster care worker indicates whether referral to IV-D is needed. The form also contains information regarding the non-custodial parent.
b. If the DSS-5120 has not been received when the DSS-8124 is keyed, exit the referral screen by pressing PF2 and complete referral at a later date, if necessary.
c. Always enter the SIS Number on the Children Being Referred screen. When transferring a foster care case to another county a new SIS# must be assigned. Contact the child’s social worker in your county.
2. Exempt I-AS and H-SF adolescents in the Expanded Foster Care Program (EFCP) from cooperating with Child Support when they are caretakers of minor children. There is no child or medical referral requirement for a foster adolescent who now has a child, as long as the individual remains covered in the Expanded Foster Care Program. However, if the individual’s category of coverage is changed to a family group where child support requirements must be met as a condition of eligibility for the caretaker, then make a referral to Child Support.
REISSUED EFFECTIVE 04/01/10 – CHANGE NO. 04-10