Case Closure of Child-Only Medicaid Cases

POLICY INTERPRETATION QUESTIONS

PIQ-03-09

DATE: July 25, 2003

TO: State IV-D Directors

FROM: Sherri Z. Heller, Ed.D.
Commissioner
Office of Child Support Enforcement

SUBJECT: Case Closure of Child-Only Medicaid Cases

The Office of Child Support Enforcement has received inquiries asking for policy guidance regarding appropriate case closure criteria for child-only Medicaid cases when the custodial parent requests closure of the IV-D case or when the custodial parent refuses to cooperate.

QUESTION 1: If, in a child-only Medicaid case referred and opened as a IV-D case under 45 CFR 302.33(a)(1)(ii), the custodial parent requests closure and there is no assignment of arrearages which accrued under a support order, may the IV-D agency close that case under 45 CFR 303.11(b)(8)?

RESPONSE 1: When a custodial parent files a Medicaid application on behalf of a child only, the custodial parent is not bound by the requirement in section 1912 of the Social Security Act (the Act) to assign the child's rights to support and payment. However, section 1902(a)(25)(H) of the Act requires that states have laws automatically assigning an individual's right to payment for medical care by third parties, to the extent that Medicaid has made a payment.

If a state has enacted the type of law required by section 1902(a)(25)(H), and Medicaid made payment(s), a 42 CFR 433.146 medical support assignment to the state would occur by operation of law. In that instance, a custodial parent’s request for IV-D case closure should be denied. The IV-D case would need to be kept open as long as a medical support assignment to the state remained. Alternatively, if such a law were enacted, Medicaid never made a payment, and no assignment existed of arrearages accruing under a support order, 45 CFR 303.11(b)(8) would permit the IV-D agency to close the case.

QUESTION 2: If, in a child-only Medicaid case referred and opened as a IV-D case under 45 CFR 302.33(a)(1)(ii), the IV-D agency documents that the custodial parent has not cooperated and an action by the custodial parent is essential for the next step in providing IV-D services, after meeting notice and waiting period requirements, may the agency close the case under 45 CFR 303.11(b)(11)?

RESPONSE 2: On its face, 45 CFR 303.11(b)(11) does not apply to IV-D cases opened under 45 CFR 302.33(a)(1)(ii). Accordingly, the IV-D case must remain open. Based on the information provided in this question, it would not be appropriate for the IV-D agency to close this case, since it does not fit any of the criteria for case closure set forth in 45 CFR 303.11.

Inquiries should be directed to the appropriate Regional Office

cc: ACF Regional Administrators
Regional Program Managers