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Title 8: Medicaid Page 25 Iowa Department of Health and Human Services Employees’ Manual Chapter C: Nonfinancial Eligibility Cooperation with Child Support Services Revised October 10, 2025 Good Cause for Refusal to Cooperate If a member claims good cause, continue Medicaid pending receipt of the evidence in the required time frame. If the member fails to provide the needed proof by the due date, cancel the member’s Medicaid. See Failure to Cooperate in Obtaining Support. Once the applicant or member has provided all necessary proof, process the good cause claim. See Making the Decision About Good Cause. Comment: The following sections give more information on:  Determining if good cause exists  Evidence of physical and emotional harm  Client responsibilities when filing a good cause claim  Worker responsibilities when a good cause claim is filed  Making the decision about good cause Determining if Good Cause Exists Legal reference: 441 IAC 75 (Rule in Process) Good cause exists when cooperation in establishing liability and securing support is against the best interest of the child. Cooperation is against the best interests of the child only if one of the following exists:  The child for whom medical support is sought was conceived as a result of incest or forcible rape.  Legal adoption proceedings are pending before a court of competent jurisdiction.  The applicant or member has been working with a public or licensed private social agency less than three months to decide whether to keep the child or relinquish the child for adoption.  It is reasonably anticipated that cooperation would result in physical or emotional harm to the child for whom medical support is being sought.  It is reasonably anticipated that cooperation would result in physical or emotional harm to the parent or other caretaker with whom the child is living which reduces the person’s capacity to care for the child adequately. Evidence of Physical and Emotional Harm Legal reference: 441 IAC 75.14 Physical and emotional harm must be of a serious nature in order to justify a finding of good cause.