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Title 8: Medicaid Page 23 Iowa Department of Health and Human Services Employees’ Manual Chapter C: Nonfinancial Eligibility Cooperation with Child Support Services Revised October 10, 2025 What the Client Must Do to Cooperate

1. The households consist of Ms. J; her daughter, Mary, age 17; and Mary’s daughter Ann, age 2. This household receives Medicaid under the MAGI-related Medicaid coverage group. The worker requires Mary to cooperate with CSS on Ann’s father. The worker also requires Ms. J to cooperate with CSS on Mary’s absent father. 2. Mr. J, age 32, receives Medicaid for Larry, his nephew, age 4. The worker requires Mr. J to cooperate with CSS in obtaining medical support from Larry’s parents, because Mr. J is acting in a parental capacity. Pregnant Women Who Are Exempt from Cooperation Legal reference: 441 IAC 75 (Rules in Process) Pregnant and postpartum women who are eligible for Medicaid under the Mother and Children (MAC) coverage group do not have to cooperate in establishing liability and obtaining medical support for their Medicaid eligible born children. Pregnant women eligible under a coverage group other than MAC must cooperate in establishing liability and obtaining support. If the woman fails or refuses to cooperate, cancel eligibility under her current coverage group, complete an automatic redetermination and establish eligibility under MAC.

1. Ms. D, age 32 and pregnant, receives Medicaid for herself and her two children, ages 6 and 8, as a household of four. Ms. D failed to cooperate with CSS. (Ms. D has an active CSS case). Ms. D’s Medicaid eligibility is automatically redetermined under the MAC coverage group since cooperation is not an eligibility factor under MAC for pregnant women. Ms. D is informed that she will be required to cooperate when her postpartum period expires. 2. Ms. B, age 23 and pregnant, receives Medicaid for herself and her two children, ages 2 and 4, under MAC coverage group. Ms. B previously requested CSS services and a referral to CSS was made. Ms B has now failed without good cause to cooperate with CSS. The IM worker takes no further action, since no sanction can be applied until the postpartum period expires.