M E M O R A N D U M

IM-6  01/11/00   FAILURE TO COOPERATE - MEDICAL SUPPORT


SUBJECT:
FAILURE TO COOPERATE WITH REGARD TO MEDICAL SUPPORT
MANUAL REVISION #3 FAMILY HEALTHCARE
IMNL Sections 0905.010.40, 0905.010.45.10, 0910.040.00, 0920.010.35.05
 
DISCUSSION:
Eligibility for MC+ healthcare coverage cannot be denied or terminated for a child due to the refusal of another person to cooperate in establishing paternity or obtaining medical support for the child.  Therefore, sanction of a parent or caretaker for failure to cooperate should not affect the eligibility of the child.  Health Care Financing Administration (HCFA) issued policy clarification that allows states to leave the sanctioned parent in the assistance group. 

Effective immediately for Medical Assistance for Families (MAF) and MC+ cases, do not reduce the size of the child's assistance group on the basis that a parent refused to cooperate in establishing paternity and pursuing medical support.  The family size and need remain the same for MC+ healthcare coverage purposes, whether or not the parent cooperates.   Failure to cooperate will make the caretaker ineligible for MC+ healthcare coverage, except MC+ for Pregnant Women.

As an included member of a MAF assistance group, the sanctioned person is considered a caretaker relative.  When applicable, eligibility for Transitional Medical Assistance exists for the children but not the caretaker.

NOTE: There is no change in policy and procedures with regard to sanctioning for Temporary Assistance.

MAF cases without cash will not accept a "S" (sanctioned) level of care. As an included member of a MAF assistance group, the sanctioned persons must be shown as a "C" level of care.   Sanctioned individuals are shown as included individuals on the IMU5 on C7 cases.  It must be noted in the case file the individual is sanctioned, reason for sanctioning, etc., to insure the individual is not inappropriately added to MAF or as a Custodial Parent.

IMNL sections 0905.010.40, 0905.010.45.10, 0910.040.00, 0920.010.35.05 have been revised to reflect this change.

 
NECESSARY ACTION:
  • Share this memorandum with appropriate staff.

  •  
  • Include the sanctioned individual when determining eligibility for the child(ren).

  •  
  • File the revised manual pages in the hard copy of the Family Healthcare Manual.
CSW
Distribution # 2

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