State of Wisconsin Department of Health Services

HISTORY

The policy on this page is from a previous version of the handbook. 

19-02 Version of 5.2 Medical Support/Child Support Agency Cooperation

5.2.1 Introduction

Unless the person is exempt or has good causeThe circumstances beyond a person's control which keep the person from following program requirements or specific eligibility conditions, such as premium payment or cooperation with medical support. for refusal to cooperate (see Section 5.2.2 Exemptions from Cooperation and 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

5.2.2 Exemptions from Cooperation

The caretaker relative is exempt from the requirement to cooperate and exempt from any sanction for non-cooperation if:

1. The child under their care is eligible for benefits funded under any source other than Title 19, such as Title 21 (Separate CHIP) or General Purpose Revenue (that is, state funds). 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.
2. The child under their care is on SSI.
3. The caretaker relative is:
   1. Eligible for the BadgerCare Plus Extension,
   2. A pregnant woman, until the end of the month in which the 60th day after the termination of pregnancy occurs.
   3. Under 18 years old.
4. Both absent parents are now living in the home with the child.
5. Absent parent is deceased.
6. Paternity has been established and the father is living in the home with the mother and child.
7. The only parent absent from the home is absent because of military service.

5.2.3 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) and whether the applicant or member is exempt (see Section 5.2.2 Exemptions from Cooperation). If there is a dispute, the CSA makes the final determination of cooperation while the IM agency makes the final determination of exemptions or good cause. The member remains ineligible until they cooperate or establish good cause or their cooperation is no longer required.

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

 

Example 1

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.

 

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The information concerning the BadgerCare Plus program provided in this handbook release is published in accordance with: Titles XI, XIX and XXI of the Social Security Act; Parts 430 through 481 of Title 42 of the Code of Federal Regulations; Chapter 49 of the Wisconsin Statutes; and Chapters HA 3, DHS 2 and 101 through 109 of the Wisconsin Administrative Code.

Publication Number: P-10171