Page 128

UPDATED: JUNE 2010

565

OTHER ELIGIBILITY REQUIREMENTS LEGALLY RESPONSIBLE RELATIVES (LRRs) PARENTS AND CHILDREN

IV-D REQUIREMENTS

The local district:

(1) mails or provides all client books at application and recertification, including Client Information Book I (DSS- 4148A), which addresses clients’ rights and responsibilities regarding child support;

(2) advises all Medicaid-Only A/Rs in writing via the DOH-4220 (ACCESS NY application), unless they are otherwise exempt, that, as a condition of initial and ongoing eligibility, they will be required to cooperate in:

(a)obtaining third party health insurance (TPHI) and…#

(a) obtaining third party health insurance (TPHI) and medical payments for themselves and any other individuals for whom the Medicaid-Only A/R can legally assign rights;

(b)establishing paternity of a child born out of wedlock…#

(b) establishing paternity of a child born out of wedlock for whom the Medicaid-Only A/R can legally assign rights; and

(c)obtaining medical support for their children (unless it…

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Page 128

Official source

UPDATED: JUNE 2010

565

OTHER ELIGIBILITY REQUIREMENTS LEGALLY RESPONSIBLE RELATIVES (LRRs) PARENTS AND CHILDREN

IV-D REQUIREMENTS

The local district:

(1) mails or provides all client books at application and recertification, including Client Information Book I (DSS- 4148A), which addresses clients’ rights and responsibilities regarding child support;

(2) advises all Medicaid-Only A/Rs in writing via the DOH-4220 (ACCESS NY application), unless they are otherwise exempt, that, as a condition of initial and ongoing eligibility, they will be required to cooperate in:

(a)obtaining third party health insurance (TPHI) and…#

(a) obtaining third party health insurance (TPHI) and medical payments for themselves and any other individuals for whom the Medicaid-Only A/R can legally assign rights;

(b)establishing paternity of a child born out of wedlock…#

(b) establishing paternity of a child born out of wedlock for whom the Medicaid-Only A/R can legally assign rights; and

(c)obtaining medical support for their children (unless it…

#

(c) obtaining medical support for their children (unless it is a child-only MA case).

NOTE: Pregnant women should not be referred to the CSEU until after the 60-day post partum period. To the extent possible, prior to such referral, local districts continue to pursue the availability of TPHI. If a pregnant minor does not want her parents contacted, however, TPHI is not pursued. All other Medicaid-Only A/R’s must cooperate in establishing paternity and securing medical support.

An A/Rs failure, without good cause or other exemption, to cooperate renders such person ineligible for Medicaid. Their children under age 21, however, are authorized to receive Medicaid if they are otherwise eligible;

(MRG)