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Title 8: Medicaid Page 32 Iowa Department of Health and Human Services Employees’ Manual Chapter B: Application Processing Referrals to CSS Revised October 17, 2025 Referral Procedures

2. Mr. W applies only for Medicaid for himself and his two children. He says on the application that:  He does not want to pursue child support, and  The absent parent is court-ordered to pay cash medical support. The IM worker explains to Mr. W that a referral will be made to CSS because of the cash medical support order; that he is required to cooperate with CSS to receive Medicaid for himself; and that if he does not cooperate, he will not receive Medicaid for himself. 3. Mr. Q applies for FIP, Medicaid, and Food Assistance for himself and his children. His children’s mother is absent from the home. Mr. Q says on the application that:  He does not want to cooperate in obtaining medical support,  CSS is not helping him, and  There is no court order for cash medical support. The worker tells Mr. Q that as a condition of eligibility for FIP he must cooperate with CSS in obtaining financial support or the household will be subject to sanction of cash benefits. The worker completes a CSS referral and it will be “active” for both FIP and Medicaid programs. If Mr. Q later fails to cooperate with CSS, then CSS will notify the worker to apply the appropriate sanctions to the FIP, Medicaid, and Food Assistance benefits. Referral Procedures Procedures: If the household has more than one absent parent and there is no active CSS case, the applicant can determine which absent parents are to be referred, if any. For foster care cases, link both parents. If the ICAR referrals have not been made, complete the referral. Pregnant Women Legal reference: 441 IAC 75 (Rules in Process) Policy: As a condition of her eligibility, the woman must agree to cooperate in establishing paternity and obtaining support for the children for whom she receives Medicaid (except for pregnant women under MAC). However, a woman will be referred only as listed under Referrals to CSS.