8.2 Medical Support/Child Support Agency Cooperation

8.2.1 Introduction
8.2.2 Exemptions from Cooperation
8.2.3 Failure to Cooperate

8.2.1 Introduction

Unless the person is exempt or has good cause for refusal to cooperate (see Section 8.2.2 Exemptions from Cooperation and Section 8.3 Claiming Good Cause), each applicantA person who has submitted a request for coverage for whom no decision has been made regarding eligibility or memberA recipient of Medicaid; formerly referred to as a "client." who is referred, must, as a condition of eligibility, cooperate in both the following:

Establishing the paternity of any child born out of wedlock for whom BadgerCare Plus or Medicaid, including Medicare Savings Programs, is requested or received
Obtaining medical support for the applicant and for any child for whom Medicaid, including Medicare Savings Programs, 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 Child Support Agency (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.

8.2.2 Exemptions from Cooperation

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

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). Information on children’s categories funded by Separate CHIP or state funds is available in BadgerCare Plus, Section 51.1 BadgerCare Plus Categories. The CSA will monitor the child's Medicaid Eligibility funding source.
The child under their care is on SSI.
The parent or caretaker relative is one of the following:
1. Eligible for the BadgerCare Plus Eligibility Extension.,
2. A pregnant person, until the end of the month in which the 60th day after the termination of pregnancy occurs.
3. Under 18 years old.
4. Age 18 and receiving CHIP coverage under BadgerCare Plus (income is over 156% FPL).
Both absent parents are now living in the home with the child.
The absent parent is deceased.
Paternity has been established and the father is living in the home with the mother and child.
The only parent absent from the home is absent because of military service.

8.2.3 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 8.3.7 Determination) and whether the applicant or member is exempt (see Section 8.2.2 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 is not sanctioned.

Example 1:

Mary, a disabled parent, is applying for Medicaid 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 Medicaid and EBD Medicaid.

Mary is not eligible for EBD Medicaid or Medicaid, 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 Medicaid.

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