|
Effective: December 1, 2006 |
|
|
16.05.05ar1 - Referral Process (Archive) |
Archived: September 1, 2009 |
The worker's role in the medical support referral process is outlined below. It is important to note that it is the county child support IV-D agency , and not the worker, that is responsible for making determinations of non-cooperation.
Roles of Worker and IV-D Agency.
Referral Forms and Other Referral Documentation.
Roles of Worker and IV-D Agency
When making a medical support referral, do not delay, deny or close health care program eligibility due to non-receipt of medical support referral forms.
l If a caretaker fails or refuses to complete support forms without good cause, send all available information to the child support agency within two working days after eligibility is determined.
Note: If the caretaker claims good cause for non-cooperation, send all available information to the good cause committee.
l IV-D will determine if the caretaker is ineligible due to non-cooperation.
Note: Pregnant women are not required to cooperate; see Pregnant Women and Newborns for more information.
See below for specific instructions.
1. See When to Refer for Medical Support and Who Must Cooperate to determine if the caretaker is required to cooperate with IV-D.
2. For caretakers who are required to cooperate, send the medical support forms when you determine that a referral is required.
l Allow 30 days from the date you send the forms for the caretaker to return them.
l Do not require medical support referral forms before approving Medical Assistance (MA) or MinnesotaCare (for MinnesotaCare, case is "pending awaiting payment").
Note: For MinnesotaCare, do not refer any information to the IV-D agency until you have determined that the children are eligible and the case is active (the household has paid the initial premium).
3. When you receive the referral forms, check to see if the MinnesotaCare case is active or MA has been approved.
l If yes, send the referral to the county IV-D office within two working days.
l If no, do not send the referral until the MinnesotaCare case is active or MA has been approved.
l If the MinnesotaCare case does become active or MA eligibility is approved at a later date, send the referral within two working days.
4. If the caretaker does not claim good cause but fails to return completed forms within 30 days of being requested to do so and the MinnesotaCare case is active or MA eligibility is approved, refer available information to IV-D.
Referral Forms and Other Referral Documentation
For all referrals, send the following to the IV-D office in the caretaker's county of residence:
l The Notification of Opening/Change/Closing in Public Assistance Case (DHS-2686a).
l The Referral to Support and Collections (DHS-3163B), if received.
l The Client Statement of Good Cause (DHS-2338), if received.
l A copy of the applicable court order, if available.
In addition to the above:
l For MA, workers must also complete the appropriate MAXIS screens; see POLI/TEMP TE09.25 (PRISM Interface) for further information.
l For MinnesotaCare, workers must also include both of the following:
n A printout of the MMIS RCIN screen for all cases.
n A printout of the RCAD screen if the client does not complete the referral form.
The IV-D agency will notify you if the caretaker fails to cooperate. Send 10-day notice to terminate coverage for caretakers who fail to cooperate without good cause.
If the non-custodial parent has health insurance coverage for eligible children, the IV-D agency will provide this information to the DHS Benefit Recovery Section through a systems interface between PRISM and MMIS.
After the initial referral, use the DHS-2686a to notify IV-D of case closings or other changes.
l When a parent leaves an active household, determine if you need to make a referral for medical support. If yes:
n Send the Referral to Support and Collections (DHS-3163b) and the Client Statement of Good Cause (DHS-2338) to the custodial parent or other primary caretaker to complete.
n Request that the forms be returned within 30 days.
n Make the referral within two working days after receiving the forms.
n If the caretaker fails to return the forms within 30 days and has not claimed good cause, refer available information to IV-D within two working days of the due date.
n IV-D will notify the health care program worker if the caretaker is ineligible due to non-cooperation.
l If IV-D notifies you that a caretaker who was removed from coverage for non-cooperation has now cooperated, reinstate the caretaker's coverage:
n For MinnesotaCare, beginning the first available month after cooperation.
n For MA, back to the first of the month of cooperation. There is no minimum sanction period.
Example:
Rose and her two children have MinnesotaCare coverage. On February 10 the child support officer notifies the worker that Rose has failed to cooperate in obtaining medical support. There is no good cause claim. Rose is removed from health care coverage effective March 1. On March 15, the child support officer notifies the worker that Rose has cooperated.
Action:
Reinstate Rose's coverage effective April 1 (the first available month after cooperation). Send the DHS-2868a to notify IV-D of the reinstatement.
Note: If Rose had been eligible for MA, her coverage would have been reinstated effective March 1 (the first of the month of cooperation).