5.1 Medical Support

5.1.1 Recovery of Birth Costs 5.1.2 Referral to CSA Medical Support refers to the obligation that a parent has to pay for his or her child’s medical care, either through the provision of health insurance coverage or direct payment of medical bills. The Child Support Agency (CSA) is responsible for establishing medical support orders for some children receiving BadgerCare Plus who have an absent parent. The CSA is also responsible for establishing paternity and establishing medical support obligations for unpaid and ongoing medical support (including recovery of birth costs.)

5.1.1 Recovery of Birth Costs

When the non-marital father of the unborn child is not included in the BadgerCare Plus group at the initial eligibility determination he could be held responsible for repayment of birth costs.

5.1.2 Referral to CSA

The IM agency provides the CSA with information vital to opening medical support cases. The IM agency also supplies continuing information, which assists the CSA in providing medical support services. At confirmation, CARESThis system supports the Income Maintenance operations for DHS and DCF. CARES is used to determine eligibility, issue benefits, track premium payments, and manage support for BadgerCare Plus, EBD Medicaid, W-2, Child Care, and Work Programs. automatically sends a referral to the CSA for all BadgerCare Plus applications and person adds that include minors eligible under a Medicaid (T19) Medical Status Code, unless the referral field on the Absent Parent Page is answered ‘No’. The information on the Absent Parent Page must be filled out accurately and to the best of the worker’s ability, given that detailed questions about absent parents cannot be asked during the application process for health care-only applications. The referral will still be sent to the CSA, even if the absent parent’s name is unknown. Note: A Referral to Child Support Form (DWSW 3080) only needs to be completed when the absent parent page cannot be completed in CWWCARES Worker Web. The web-based pages used in the CARES operations.. Note: While IM agencies are to continue referring the following individuals who are receiving BadgerCare Plus, the CSA’s will be determining on their own, which cases will be provided Child Support Services. Not all BadgerCare Plus members will qualify for free Child Support services and be required to cooperate with CSA’s. The following individuals (including minors) for whom BadgerCare Plus is requested or being received, must be referred to the local CSA unless an exception is noted:

Pregnant woman who is unmarried or married and not living with her husband.

Pregnant women are not required to cooperate with the CSA during the pregnancy and for two months after the end of pregnancy. The woman's eligibility for BadgerCare Plus will continue during this period, regardless of her cooperation.

Exception: Do not refer pregnant women receiving the BadgerCare Plus Prenatal Benefit to CSA.

Child receiving SSI only if the parent or caretaker relative requests child support services for the child. Do not sanction this parent or caretaker relative if he or she does not cooperate with the CSA.

Non Marital coparents when paternity has not been legally established. This includes a non-marital co-parent even when:

1. A Statement of Paternity (IMM, Ch. I, Appendix 29g) has been completed,
2. Both parents are in the home.
  
  Exception: Do not refer parents to the CSA when both parents are in the home and the father's paternity has been legally established. (Paternity is legally established by a court order or by a Voluntary Paternity Acknowledgment Form signed on or after May 1, 1998 and filed with the Wisconsin Vital Records office.)

Note: If a father's name appears on a Wisconsin Birth Certificate for a child born after 5/11/1998, it means paternity has been established.

Natural or adoptive parent(s) not living in the household.

Exception: Do not refer to the CSA when the only reason a parent or stepparent is not in the home is because he or she is in the military.

Married natural parents in the home, but:
1. Child was born prior to their marriage, and
2. Paternity was not established by court action, or the birth not legitimized after their marriage.

Do not refer the following individuals:

Former Foster Care Youths, unless the youth is also the parent of an eligible child in the household.
Pregnant women eligible under the BadgerCare Plus Prenatal Program.

This page last updated in Release Number: 14-03

Release Date: 09/05/14

Effective Date: 09/05/14