State of Wisconsin Department of Health Services

HISTORY

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

22-03 Version of 5.1 Medical Support

Medical support refers to the obligation that a parent has to pay for their child’s medical care, either through the provision of health insurance coverage or direct payment of medical bills. The CSAChild Support Agency 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 Child Support Agencies

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 Medicaid (see T19-funded groups in Section 51.1 BadgerCare Plus Categories), 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 (such as, name, Social Security Number, date of birth, or contact information) 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 (DCF-F-DWSP3080) 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..

While IM agencies are to continue referring the following individuals who are receiving BadgerCare Plus, the CSAs 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 or 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 with the exceptions noted below:

1. Pregnant member who is unmarried or married and not living with their husband. However, pregnant members are not required to cooperate with the CSA during the pregnancy and for an additional 60 days after the last day of pregnancy and through the end of the month in which the 60th day occurs. The member's eligibility for BadgerCare Plus will continue during this period, regardless of the member's cooperation. 
   1. Exception: Pregnant members receiving the BadgerCare Plus Prenatal Benefit should not be referred to a CSA.
2. 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 they do not cooperate with the CSA.
3. Non-marital co-parents when paternity has not been legally established, even when both parents are in the home.
   1. Exception: Do not refer parents to the CSA when both parents are in the home and the father is on the child’s birth certificate or the father's paternity has been legally established in another state by a court order or by a Voluntary Paternity Acknowledgment Form filed with a state agency.
4. Biological or adoptive parent(s) not living in the household. 
   1. Exception: Do not refer to the CSA when the only reason a parent or stepparent is not in the home is because they are in the military.
5. Married, biological parents in the home, but:
   1. The child was born prior to their marriage, and
   2. Paternity was not established by court action or established after their marriage.

In addition, do not refer the following:

• Former Foster Care Youth unless the youth is also the parent of an eligible child in the household.
• People residing in domestic abuse shelters. Once a person moves out of a domestic abuse shelter, complete the Absent Parent page in CWW so that the referral is sent to the CSA.

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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