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Medical Support Enforcement Requirement


Published: January 24, 1992
Information About:
State/Local Child Support Agencies
Case Management, Medical Support, Family Services & Referrals, Health Care Coverage
Policy, Dear Colleague Letters (DCL)


RE: How IV-D Agencies may meet the Medical Support Enforcement Requirement in 45 CFR 303.30 (C) & 303.31(B) (8).

Dear Colleague:

It has come to our attention that there have been differing interpretations by States regarding the requirements for State child support enforcement (IV-D) agencies to forward medical support information to Medicaid agencies may meet the medical support enforcement requirements in 45 CFR 303.30 (c) and 303.31 (b) (8).

oThe Federal regulations, at 45 CFR 303.30 (c), require IV-D agencies to forward medical support information to Medicaid agencies in a timely and cost effective manner. A State

IV-D agency may meet this requirement if the IV-D agency develops, in conjunction with the Medicaid agency, procedures for how the IV-D agency will provide medical support enforcement information to the Medicaid agency, including when the information is to be shared. For example, some IV-D agencies have indicated that their Medicaid agencies would prefer that the information required under 45 CFR 303.30(a) not be sent until the IV-D agency is able to provide specific health insurance policy information, under 45 CFR 303.30(a) (7). This is because the Medicaid agency only pursues payment from liable third parties; it does not establish liability. State procedures which provide for this approach are acceptable.

oThe Federal regulations, at 45 CFR 303.31(b) (8), require IV-D agencies to periodically communicate with the Medicaid agency to determine if there have been lapses in health insurance coverage for Medicaid applicants and recipients. A State IV-D agency may meet this requirement if the Medicaid agency agrees in writing to provide to the IV-D agency information about lapses and changes of coverage when they are identified by the Medicaid agency. For example, the Medical agency would notify the IV-D agency if a claim

has been rejected by the parent's health insurance company because the health insurance policy has been canceled orrevised to no longer cover the children who are receiving IV-D services.


Allie Page Matthews

Deputy Director

cc: ACF Regional Administrators

Regions I - X