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Manual Title Chapter Page Revision Date Virginia Medical Assistance Eligibility M02 October 2013 Subchapter Subject Page ending with Page M0250 ASSIGNMENT OF RIGHTS AND PURSUIT OF SUPPORT M0250.300 3

2. Documentation Document the case record with the reason(s) the individual refuses to cooperate in identifying and providing liable third party information and the reason(s) the agency finds that cooperation is against the best interests of the individual or other person for whom he/she can assign rights.

M0250.300 PURSUIT OF MEDICAL SUPPORT FROM THE ABSENT PARENT

A. Policy To be eligible for Medicaid, an individual applicant or recipient must cooperate with the agency in obtaining medical support and payments from, or derived from, the absent parent(s) of a child for whom the individual is applying, unless the individual establishes good cause for not cooperating. The individual’s non-cooperation does NOT affect the individual’s Plan First eligibility, nor the individual’s child(ren)’s Medicaid eligibility. A pregnant woman is not required to cooperate with DCSE when requesting assistance for herself and her child(ren) born out of wedlock. If she is or was married, she is required to cooperate in pursuing medical support for her legitimate child(ren) from the legitimate child(ren)’s absent father. A married pregnant woman who meets the medical assistance support requirement cannot be denied medical assistance for failure to cooperate in pursuing support even when ineligible for another program because of failure to cooperate with pursuit of support. B. Definition of Cooperation 1. Application By signing the application for Medicaid, the individual meets the eligibility requirement to cooperate in pursuing support from the absent parent(s) of the child for whom the individual is applying. No further action by the applicant is required at the time of application. The individual is not required to contact DCSE about pursuing support from the absent parent. If the individual chooses to request DCSE services, the individual’s continued cooperation with DCSE is required for the individual to remain eligible for Medicaid. 2. Ongoing After the individual’s application has been approved, if DCSE, DMAS or the local agency requests information from the individual about the absent parent, or otherwise requires the individual’s cooperation with the pursuit of medical support from the absent parent, the individual must cooperate in order for the individual’s eligibility to continue. Medicaid enrollees who were approved for Medicaid before January 1, 2007, and who were referred to DCSE, must continue to cooperate with DCSE in the pursuit of medical support from the absent parent to remain eligible for Medicaid. C. Local DSS Agency Responsibility