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2434.30.00 CIRCUMSTANCES WHEN PENALTIES ARE NOT APPLIED An individual can prevent a sanction by coming into compliance with the medical support obligations within the 20 days given by the Medical Assignment Good Cause Notice (FI 2009). In addition to successfully claiming good cause a person can demonstrate compliance within the 20 days by providing proof of a scheduled appointment with the IV-D office. Also, please note that Medicaid eligibility must be approved/continued for the minor applicant/recipient whose custodial parent or legal guardian refuses, without good cause, to cooperate in obtaining medical support.

Example: A recipient father refuses to cooperate in obtaining medical support for his recipient child; the father is not eligible for Medicaid, but the child is.

2435.00.00 HEALTH INSURANCE PREMIUM PAYMENT PROGRAM The Indiana Medicaid through the Health Insurance Premium Payment Program (HIPP) pays for health insurance premiums of Medicaid-eligible Individuals when it is cost effective for the State. HIPP is required to purchase (wherever available and cost effective) employer-based group health insurance on behalf of covered Medicaid recipients and makes enrollment in this type of insurance plan a condition of the covered recipients' Medicaid eligibility, (exceptions below).97 Exceptions: • Policyholder is an absent parent who is court ordered to maintain the insurance • Member has Medicare coverage (Medicare recipients are ineligible for HIPP Program). • Member is enrolled with Managed Care Entity (MCE). • Insurance that only provides catastrophic limited benefit, limited duration, or indemnity coverage. • Premiums that are fully reimbursed by an employer, subsidy, or another third party.

Note: Non-members who do not meet eligibility requirements (i.e., no eligible household members, failure to enroll in a group health plan, etc.) are deemed ineligible for HIPP. If a non- Medicaid eligible family member must be enrolled in the group health plan to obtain coverage for the Medicaid eligible member, Fee for Participation (FFP) is available for premiums only (no other cost sharing expenses) for the non-Medicaid eligible family member(s). 98 A family member may reside in a separate household.

Potential HIPP cases are identified by DFR or a TPL Casualty Analyst. If a worker believes an individual and/or their dependent enrolled in the IHCP meet eligibility requirements for the HIPP