Family Medicaid TPL Requirements
Family Medicaid A/Rs must provide information regarding a TPL held by a non-custodial parent unless good cause is asserted and upheld. Good cause for refusing to cooperate is based on Division of Child Support Services good cause and non-cooperation standards.
Complete Form 138 - Notice of Requirement to Cooperate and Right to Claim Good Cause for Refusal to Cooperate with DCSS to document waiver of the TPL requirement because of Good Cause for non-cooperation with DCSS.
An adult A/R is penalized for failure to cooperate with the TPL process. If there are two adults in the AU, both would be penalized if there is no TPL cooperation.
Recipients of Newborn Medicaid are not required to provide information regarding TPLs.
A child is never penalized or excluded from the AU because of an adult’s failure to cooperate with TPL.
Refer to Section 2657 - Penalized Individuals for information regarding Family Medicaid failure to comply with TPL requirements.
Children covered by other public or private health insurance (except vision or dental insurance) are ineligible to receive PeachCare for Kids®. PeachCare for Kids® enrollees may only be denied/terminated for TPL at application or renewal due to continuous eligibility restrictions.
For children in DFCS custody, refer to Problem Resolutions with Medicaid Billing and TPL and Children in Placement .