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Title 8: Medicaid Page 33 Iowa Department of Health and Human Services Employees’ Manual Chapter B: Application Processing Referrals to CSS Revised October 17, 2025 Pregnant Women Procedure: Do not make a referral regarding the father of the unborn child until the postpartum period has ended. Then refer only if the mother requests a CSS referral or is otherwise required. See also 8-C, Cooperation With Child Support Services, and 8-F, Mothers and Children (MAC) Program.

1. Ms. A is pregnant and lives alone. She applies for Medicaid. No CSS referral is made and no information is requested regarding the father of the unborn child. The worker does not make a referral until the postpartum period has ended, and then only if Ms. A requests CSS services. 2. Ms. B is pregnant and lives with her two children. She applies for Medicaid for herself and the children. Eligibility is examined under the FMAP coverage group. The worker makes the referral to CSS only if Ms. B wants CSS services or if CSS already has an active ICAR case. When the postpartum period ends, the worker refers the newborn if a referral was made on the other children of this absent parent. 3. Ms. D is pregnant and receives Medicaid under the MAC coverage group for herself and her daughter. Ms. D wishes to have CSS establish paternity and support for her daughter. The worker makes the referral to CSS for the daughter. 4. Same as Example 5. The referral is made to CSS. However, Ms. D changes her mind and does not cooperate with CSS. Her Medicaid is not canceled, because she receives Medicaid under MAC as a pregnant woman, and is, therefore, exempt from the cooperation requirement. Representation Legal reference: 441 IAC 76.9 A Medicaid applicant or member may need or want to be represented by another person or organization.  When an applicant or member is a minor, incompetent, incapacitated, or deceased, a “responsible person” is allowed to act on the client’s behalf.  A competent person may name an “authorized representative” to participate in pursuing Medicaid eligibility.