*** The Health Care Programs Manual (HCPM) has been replaced by the Minnesota Health Care Programs Eligibility Policy Manual (EPM) as of June 1, 2016. Please refer to the EPM for current health care program policy information. ***

Chapter 16 - Medical Support

Effective:  July 1, 2008

16.20 - Parental Fees

Archived:  June 1, 2016 (Previous Versions)

Parental Fees

For Medical Assistance (MA) coverage, parents may be liable for a fee to reimburse part of their children's costs if they do not live with their minor children, or, if their income is not considered in determining MA eligibility for their disabled children.

Note:  There are no provisions for parental fees for MinnesotaCare.

Depending on the circumstances, the parental fee may be assessed by either the county agency or by the Department of Human Services (DHS). However, parents are not responsible for a parental fee in any of the following circumstances:

l  Parental rights have been terminated.

l  The child on MA is an emancipated minor.

l  The child receives state or Title IV-E adoption assistance.

Fees Assessed by County Agency.

Fees Assessed by DHS.

How Is the Fee Determined?

Non-Cooperation with Parental Fee Requirements.

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Fees Assessed by County Agency

The county agency may assess parental fees when a child lives apart from both parents. Depending on the child's circumstances, the parents may be determined to be custodial or non-custodial. See Minor Child Lives Apart From Both Parents for the determination criteria.

l  Follow your agency's procedures to pursue a parental fee from parents who are determined to be "custodial."

l  Make a medical support referral for parents who are determined "non-custodial."

Exception:  If a child is in a Title IV-E Foster Care placement, follow your agency's procedures for Title IV-E referrals.

In county agencies, procedures for assessing parental fees vary. In some counties, the IV-D Agency may pursue parental fees along with child and medical support orders. Other counties may have separate staff handling parental fees. Follow your agency's procedures.

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Fees Assessed by DHS

DHS collects parental fees for disabled children with certain types of MA eligibility or living arrangements. Refer cases to DHS for disabled children who are eligible for MA and meet any of the following:

l  Eligible through the TEFRA option.

l  Receive services through the home and community-based waiver programs.

l  Are in 24-hour out-of-home placement.

For information on how to refer these cases to DHS for collection of parental fees, see Refer to DHS for Parental Fee.

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How Is the Fee Determined?

The formula that DHS uses to determine the parental fees it collects is given in Computation of Parental Fees. Counties may use this same formula to assess parental fees for social services costs but are not required to do so.

For fees collected by DHS, after the state fiscal year ends each June, parents will receive a statement showing the cost of MA services paid for the child in relation to the parental fee paid. If the parents paid more than the cost of MA services:

l  The difference is transferred as a credit toward the next fiscal year (if a fee will be assessed), or

l  The money is reimbursed to the parent when the child turns 18 or the child’s eligibility changes to a type that is not assessed a fee.

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Non-Cooperation with Parental Fee Requirements

Do not deny or close a child's health care coverage because a parent does not cooperate with parental fee requirements. However, for fees collected by DHS, action may be taken against the parent in either of the following circumstances:

l  They refuse to provide DHS with the necessary information to determine their fee. In this case, they will be required to reimburse the full cost of MA services.

l  They fail to pay their parental fee. The action taken may include the account being turned over to a collection agency, garnishment of wages, or taking the parent's State tax refund.

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