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Federal Income Tax Refund Offset Program to Recoup Medical or Birthing Expenses Owed to State


Published: February 6, 2007
Information About:
State/Local Child Support Agencies
Medical Support
Policy, Policy Interpretation Questions (PIQ)
Child Support Guidelines, Collection & Enforcement Systems



DATE:February 6, 2007

TO: State and Tribal IV-D Directors

SUBJECT: Use of Federal Income Tax Refund Offset Program to recoup medical expenses or birthing expenses owed to a State

QUESTION 1: Do guidelines apply to the establishment of medical support orders for birthing expenses?

RESPONSE 1: Yes. Guidelines apply to the establishment of any child support order. Medical support is a subset of child support and child support orders must be established using guidelines which must at a minimum: take into consideration all earnings and income of the noncustodial parent; be based on specific descriptive and numeric criteria and result in a computation of the support obligation; and provide for the child(ren)’s health care needs, through health insurance coverage or other means, in accordance with 45 CFR 302.56. In seeking judgments or awards for retroactive medical support, including birthing expenses, the IV-D agency must use the guidelines and take into consideration the obligated parent’s ability to pay, or justify the deviation from the application of the guidelines.

QUESTION 2: May a State IV-D agency submit for Federal Income Tax Refund Offset past-due medical support, whether cash medical support or judgments for birthing costs, set in accordance with State guidelines?

RESPONSE 2: Yes. Past-due medical support set in accordance with State guidelines may be submitted for Federal income tax refund offset if the requirements in 45 CFR 303.72 are met. Federal regulations at 45 CFR 303.72(a) define past-due support qualifying for Federal income tax refund offset to include past-due support owed in cases with assigned support and in cases in which the IV-D agency is providing services under §302.33. Regulations of the Department of the Treasury at 31 CFR 285.3(c)(1) authorize the submission of past-due support for Federal income tax refund offset in cases in which support has been assigned to the State or cases in which the State is providing collection services under section 454(4) of the Social Security Act. Both sets of regulations cover all types of IV-D cases.

Margot Bean
Commissioner, Office of Child Support Enforcement

CC: ACF Regional Administrators
ACF OCSE Regional Program Managers