Effective Date: April 1, 2018

Previous Policy

Refusal to Cooperate - Applicant

If an applicant refuses to cooperate, mail the form 619M. Allow 10 days to claim good cause. If she does not cooperate or claim good cause by the due date, she is not eligible for medical assistance. Give proper notice.

Refusal to Cooperate - Recipient

After a recipient has agreed to cooperate, she needs to complete the initial ORS/CSS application process.

Refusal to cooperate is when a recipient:

States that she will complete the initial ORS/CSS application process, but fails to do so, and does not want to claim good cause for not cooperating.

Claims good cause for not completing the initial ORS/CSS application process, and then refuses to cooperate when the initial good cause claim is denied.

Completes the initial ORS/CSS application process and then refuses to provide additional information requested by ORS/CSS and does not want to claim good cause or still refuses to provide the information if the good cause claim is denied.

If the recipient does not cooperate, the ORS/CSS worker will notify the eligibility worker.

If the parent/caretaker relative claims good cause for not cooperating, no sanction can be applied until the good cause procedures are completed. ORS/CSS will stop all action on the Medical Support Enforcement case until the good cause process is complete ( 227-3 and 227-4 ).

If a parent/caretaker relative refuses to cooperate with Medical Support Enforcement as described in No.1, a., b. or c. above and does not claim good cause or the good cause claim is denied, the parent or caretaker relative is ineligible for any Medicaid program.

Provide ORS/CSS with any information you may have regarding the absent parent(s) of the children.

ORS/CSS will still pursue Medical Support Enforcement for the children on child Medicaid cases even if the parent/caretaker relative refuses to cooperate and has been sanctioned.

Inform the recipient the Medical Support Enforcement will proceed as long as the children continue to receive Medicaid.

If the child is eligible for blind or disabled Medicaid, sanction the non-cooperating parent and caretaker relative and continue coverage for the child under the blind or disabled Medicaid program. Inform ORS/CSS that the non-cooperating adult has been sanctioned and they should not pursue support enforcement for the child.

If the parent or caretaker relative could be eligible under the parent/caretaker relative group, aged, blind or disabled Medicaid or Medicare Cost-Sharing programs, the parent or caretaker relative may choose to have the child's Medicaid coverage closed so that he or she may receive coverage. In this case, inform ORS/CSS that the child's Medicaid case has been closed and they should not pursue support enforcement for the child.