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Child Support Services ENFORCEMENT

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MEDICAL SUPPORT ENFORCEMENT

    1. General medical support enforcement policies;
    2. The medical support enforcement process;
    3. The National Medical Support Notice (DSS-4733).
    1. The use of contingent language in the order requiring the noncustodial parent (NCP) to notify the court or CSS agency when ordered coverage is obtained or terminated. (See the recommended language that follows.)
    1. Sending the National Medical Support Notice (DSS-4733) to the NCP's employer(s) within five (5) days of the entry of an order that contains a provision for employment-related medical insurance coverage for the child(ren).
    2. Verification that coverage has been obtained as ordered or enrollment of the child if the parent fails to do so.
    3. Upon verification of a change in an NCP's employment or as a result of New Hire reporting, sending a National Medical Support Notice (DSS-4733) to the NCP's employer(s) if the court order contains a provision for employment-related medical insurance coverage for the child(ren).
    4. Review of cases with other pending court action for compliance with the medical support provisions, and if appropriate, inclusion of contempt action for noncompliance.
    5. Citation of the NCP for contempt when not complying with the medical support provisions of the order, even if child support payments are current.
    6. If both income withholding and insurance premiums are being deducted from earnings, verification that total deduction does not exceed the maximum amount allowed by State law.
    7. A motion to join employer who refuses to comply with requests to enroll the child(ren), in order to compel enrollment. Civil legal action also can be taken against the health plan administrator if coverage is available but the NCP’s child is not enrolled.
    8. Communication with the Medicaid agency for the exchange of information regarding medical coverage (EX: the transmittal of new coverage information if the NCP changes jobs and notification of any lapses in coverage of Medicaid applicants and recipients.)
    9. Communication with employers and others who offer group health insurance coverage being enforced by CSS, requesting notification to the CSS agency of any lapses in coverage. (If coverage terminated but still available, ensure that child not disenrolled without proof of termination of order or enrollment in other coverage.)
    10. Implementation of income withholding for medical support designated as a specific dollar amount.
    11. Monitor the insurance coverage status of cases for which the NCP has group insurance in place that is not employment-related.
    1. Is eligible for or receiving Medicaid;
    2. Was born out-of-wedlock;
    3. Is not claimed as a tax dependent of that parent;
    4. Does not reside with the parent or in the insurer’s service area;
    5. Was or is in the process of being adopted by the parent;
    6. Has been placed in the foster care of the covered individual.
    1. Pre-enrollment physical examinations;
    2. Large deductibles;
    3. Pre-existing medical conditions that the policy does not cover; and/or
    4. A requirement to use only prescribed providers.
    1. Allow enrollment of a child without regard to any enrollment season restrictions;
    2. Enroll a child upon application of the child's other parent or the child support agency if the parent is enrolled but fails to apply for coverage for the child;
    3. Not disenroll or eliminate coverage of a child unless provided written evidence that the order is no longer in effect or that comparable coverage has taken effect;
    4. Provide information to the custodial parent as necessary to obtain benefits of the coverage;
    5. Permit the custodial parent to submit claims for covered services, without the approval of the NCP; and
    6. Make payments on claims to the custodial parent, the provider or DHHS, as appropriate.
    1. Allow enrollment of the child without regard to any enrollment season restrictions;
    2. Enroll the child on application of the other parent or the child support agency, if the parent is enrolled but fails to enroll the child;
    3. Not eliminate coverage for the child unless the order is no longer in effect or the child has other comparable coverage or the employer eliminates family health benefits to all employees; and
    4. Withhold the employee's share of the premiums for the health benefit coverage from the employee's compensation, not to exceed the maximum amount allowed by State law, and pay this amount to the health insurer.
    1. CSS caseworkers create a Medical Insurance Only (MIO) order, AND the NCP has a current employment record in ACTS with the availability of medical insurance documented.
    2. An Income Withholding For Support (DSS-4702) document is generated for the NCP’s new employer, the NCP’s current employment record in ACTS indicates the availability of dependent medical insurance, and the terms of the court order in ACTS indicate that the court has ordered dependent medical insurance coverage.
    3. ACTS creates an employment record as a result of data received from the New Hire database, and the terms of the court order in ACTS indicate that that dependent medical insurance coverage has been ordered.
    4. CSS caseworkers modify an existing court order in ACTS to include medical insurance for thr child(ren), AND the NCP has a current employment record in ACTS with the availability of dependent medical insurance documented.

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