5.2 Medical Support/Child Support Agency Cooperation

5.2.1 Introduction
5.2.2 Failure to Cooperate

5.2.1 Introduction

Unless the person is exempt or has good cause for refusal to cooperate (see Section 5.3 Claiming Good Cause), each applicant or member that is referred, must, as a condition of eligibility, cooperate in both of the following:

Establishing the paternity of any child born out of wedlock for whom BadgerCare Plus is requested or received
Obtaining medical support for the applicant and for any child for whom BadgerCare Plus is requested or received

Cooperation includes any relevant and necessary action to achieve the above. As a part of cooperation, the applicant may be required to:

Provide verbal or written information known to, possessed by, or reasonably obtainable by the applicant
Appear as a witness at judicial or other hearings or proceedings
Provide information, or attest to the lack of information, under penalty of perjury
Pay to the CSAChild Support Agency any court-ordered medical support payments received directly from the absent parent after support has been assigned
Attend office appointments as well as hearings and scheduled genetic tests

Note: The applicant or member is only required to cooperate if the child under his or her care is eligible for benefits funded under Title 19 or is eligible for the Medicaid expansion category of CHIPChildren's Health Insurance Program. If the child’s BadgerCare Plus benefit is funded through any other source such as Title 21 Separate CHIP or General Purpose Revenue (i.e., state funds), the caretaker relative is not required to cooperate and cannot be sanctioned for non-cooperation. Check the BadgerCare Plus categories table in Section 51.1 BadgerCare Plus Categories to determine funding source. The CSA will monitor the child’s BadgerCare Plus funding source.

5.2.2 Failure to Cooperate

The CSA determines if there is non-cooperation for people required to cooperate. The IMincome maintenance agency determines if good cause exists (see Section 5.3 Claiming Good Cause). If there is a dispute, the CSA makes the final determination of cooperation. The member remains ineligible until he or she cooperates or establishes good cause or his or her cooperation is no longer required.

The following are not sanctioned for non-cooperation:

Pregnant women
Minors
Parents or caretaker relatives while the family is in a BadgerCare Plus extension

For a pregnant woman, failure to cooperate cannot be determined prior to the end of the month in which the 60th day after the termination of pregnancy occurs.

Note: If the local CSA determines that a parent is not cooperating because court-ordered birth costs are not paid, the parent or caretaker is not sanctioned.

Example: Mary, a disabled parent, is applying for BadgerCare Plus for her and her son, Michael. She refuses to cooperate in obtaining medical support for Michael. Mary meets all other non-financial and financial criteria for BadgerCare Plus and EBD Medicaid.

Mary is not eligible for EBD Medicaid or BadgerCare Plus because she will not cooperate in obtaining medical support for Michael. Even though Mary has not cooperated in obtaining medical support for Michael, he remains eligible for BadgerCare Plus.

This page last updated in Release Number: 17-01

Release Date: 04/11/2017

Effective Date: 04/11/2017