Medical Support Enforcement Requirement
TO ALL STATE IV-D DIRECTORS
RE: How IV-D Agencies may meet the Medical Support Enforcement Requirement in 45 CFR 303.30 (C) & 303.31(B) (8).
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).
- The 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.
- The 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 or revised to no longer cover the children who are receiving IV-D services.
Allie Page Matthews
cc: ACF Regional Administrators
Regions I - X