State of Wisconsin
Department of Health Services

Release 23-04
December 18, 2023

View History

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 member that is referred must, as a condition of eligibility, cooperate in both of the following:

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

5.2.2 Exemptions from Cooperation

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

5.2.3 Failure to Cooperate

The CSA determines if there is non-cooperation for persons required to cooperate. The IMincome maintenance agency determines if good cause exists (see Section 5.3.7 Determination) 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, 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.

This page last updated in Release Number: 23-02
Release Date: 04/17/2023
Effective Date: 04/17/2023

 


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.

Notice: The content within this manual is the sole responsibility of the State of Wisconsin's Department of Health Services (DHS). This site will link to sites outside of DHS where appropriate. DHS is in no way responsible for the content of sites outside of DHS.

Publication Number: P-10171