45 CFR 303.31 - Securing and enforcing medical support obligations.

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There are 3 Updates appearing in the Federal Register for 45 CFR Part 303. View below or at eCFR (GPOAccess)
§ 303.31 Securing and enforcing medical support obligations.
Link to an amendment published at 81 FR 93566, Dec. 20, 2016.

(a) For purposes of this section:

(1) Cash medical support means an amount ordered to be paid toward the cost of health insurance provided by a public entity or by another parent through employment or otherwise, or for other medical costs not covered by insurance.

(2) Health insurance includes fee for service, health maintenance organization, preferred provider organization, and other types of coverage which is available to either parent, under which medical services could be provided to the dependent child(ren).

(3) Cash medical support or the cost of private health insurance is considered reasonable in cost if the cost to the parent responsible for providing medical support does not exceed five percent of his or her gross income or, at State option, a reasonable alternative income-based numeric standard defined in State law, regulations or court rule having the force of law or State child support guidelines adopted in accordance with § 302.56(c) of this chapter. In applying the five percent or alternative State standard for the cost of private health insurance, the cost is the cost of adding the child(ren) to the existing coverage or the difference between self-only and family coverage.

(b) The StateIV-D agency must:

(1) Petition the court or administrative authority to include private health insurance that is accessible to the child(ren), as defined by the State, and is available to the parent responsible for providing medical support at reasonable cost, as defined under paragraph (a)(3) of this section, in new or modified court or administrative orders for support;

(2) If private health insurance described in paragraph (b)(1) of this section is not available at the time the order is entered or modified, petition to include cash medical support in new or modified orders until such time as health insurance, that is accessible and reasonable in cost as defined under paragraph (a)(3) of this section, becomes available. In appropriate cases, as defined by the State, cash medical support may be sought in addition to health insurance coverage.

(3) Establish written criteria to identify orders that do not address the health care needs of children based on -

(i) Evidence that private health insurance may be available to either parent at reasonable cost, as defined under paragraph (a)(3) of this section; and

(ii) Facts, as defined by State law, regulation, procedure, or other directive, and review and adjustment requirements under § 303.8(d) of this part, which are sufficient to warrant modification of the existing support order to address the health care needs of children in accordance with paragraph (b)(1) of this section.

(4) Petition the court or administrative authority to modify support orders, in accordance with State child support guidelines, for cases identified in paragraph (b)(3) of this section to include private health insurance and/or cash medical support in accordance with paragraphs (b)(1) and (b)(2) of this section.

(5) Periodically communicate with the Medicaid agency to determine whether there have been lapses in health insurance coverage for Medicaid applicants and recipients.

(c) The IV-D agency shall inform an individual who is eligible for services under § 302.33 of this chapter that medical support services will be provided and shall provide the services specified in paragraph (b) of this section.

[73 FR 42441, July 21, 2008]

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United States Code

Title 45 published on 2015-11-20

The following are ALL rules, proposed rules, and notices (chronologically) published in the Federal Register relating to 45 CFR Part 303 after this date.

  • 2016-12-20; vol. 81 # 244 - Tuesday, December 20, 2016
    1. 81 FR 93492 - Flexibility, Efficiency, and Modernization in Child Support Enforcement Programs
      GPO FDSys XML | Text
      DEPARTMENT OF HEALTH AND HUMAN SERVICES, Centers for Medicare & Medicaid Services, Administration for Children and Families
      Final rule.
      This final rule is effective on January 19, 2017. States may comply any time after the effective date, but before the final compliance date, except for the amendment to § 433.152, which is effective on January 20, 2017. The compliance dates, or the dates that States must comply with the final rule, vary for the various sections of the Federal regulations. The reasons for delaying compliance dates include State legislative changes, system modifications, avoiding the need for a special guidelines commission review, etc. The compliance date, or the date by which the States must follow the rule, will be February 21, 2017 except, as noted below: • Guidelines for setting child support orders [§ 302.56(a)-(g)], Establishment of support obligations [§ 303.4], and Review and adjustment of child support orders [§ 303.8(c) and (d)]: The compliance date is 1 year after completion of the first quadrennial review of the State's guidelines that commences more than 1 year after publication of the final rule. • The requirements for reviewing guidelines for setting child support awards [§ 302.56(h)]: The compliance date is for the first quadrennial review of the guidelines commencing after the State's guidelines have initially been revised under this final rule. • Continuation of service for IV-E cases [§ 302.33(a)(4)], Location of noncustodial parents in IV-D cases [§ 303.3], Mandatory notice under Review and adjustment of child support orders [§ 303.8(b)(7)(ii)], Mandatory provisions of Case closure criteria [§ 303.11(c) and (d)], and Functional requirements for computerized support enforcement systems in operation by October 1, 2000 [§ 307.11(c)(3)(i) and (ii)]: The compliance date is 1 year from date of publication of the final rule, or December 20, 2017. However, if State law changes are needed, then the compliance date will be the first day of the second calendar quarter beginning after the close of the first regular session of the State legislature that begins after the effective date of the final rule. • Optional provisions (such as Paternity-only Limited Service [§ 302.33(a)(6)], Case closure criteria [§ 303.11(b)], Review and adjustment of child support orders [§  303.8 (b)(2)], Availability and rate of Federal financial participation [§ 304.20], and Topic 2 Revisions): There is no specific compliance date for optional provisions. • Payments to the family [§ 302.38], Enforcement of support obligations [§  303.6(c)( 4)], and Securing and enforcing medical support obligations [§ 303.31]: If State law revisions are needed, the compliance date is the first day of the second calendar quarter beginning after the close of the first regular session of the State legislature that begins after the effective date of the regulation. If State law revisions are not needed, the compliance date is 60 days after publication of the final rule. • Collection and disbursement of support payments by the IV-D agency [§ 302.32], Required State laws [§ 302.70], Procedures for income withholding [§ 303.100], Expenditures for which Federal financial participation is not available [§ 304.23], and Topic 3 revisions: The compliance date is the same as the effective date for the regulation since these revisions reflect existing requirements.
      42 CFR Part 433

Title 45 published on 2015-11-20.

The following are only the Rules published in the Federal Register after the published date of Title 45.

For a complete list of all Rules, Proposed Rules, and Notices view the Rulemaking tab.

  • 2016-12-20; vol. 81 # 244 - Tuesday, December 20, 2016
    1. 81 FR 93492 - Flexibility, Efficiency, and Modernization in Child Support Enforcement Programs
      GPO FDSys: XML | Text
      DEPARTMENT OF HEALTH AND HUMAN SERVICES, Centers for Medicare & Medicaid Services, Administration for Children and Families
      Final rule.
      This final rule is effective on January 19, 2017. States may comply any time after the effective date, but before the final compliance date, except for the amendment to § 433.152, which is effective on January 20, 2017. The compliance dates, or the dates that States must comply with the final rule, vary for the various sections of the Federal regulations. The reasons for delaying compliance dates include State legislative changes, system modifications, avoiding the need for a special guidelines commission review, etc. The compliance date, or the date by which the States must follow the rule, will be February 21, 2017 except, as noted below: • Guidelines for setting child support orders [§ 302.56(a)-(g)], Establishment of support obligations [§ 303.4], and Review and adjustment of child support orders [§ 303.8(c) and (d)]: The compliance date is 1 year after completion of the first quadrennial review of the State's guidelines that commences more than 1 year after publication of the final rule. • The requirements for reviewing guidelines for setting child support awards [§ 302.56(h)]: The compliance date is for the first quadrennial review of the guidelines commencing after the State's guidelines have initially been revised under this final rule. • Continuation of service for IV-E cases [§ 302.33(a)(4)], Location of noncustodial parents in IV-D cases [§ 303.3], Mandatory notice under Review and adjustment of child support orders [§ 303.8(b)(7)(ii)], Mandatory provisions of Case closure criteria [§ 303.11(c) and (d)], and Functional requirements for computerized support enforcement systems in operation by October 1, 2000 [§ 307.11(c)(3)(i) and (ii)]: The compliance date is 1 year from date of publication of the final rule, or December 20, 2017. However, if State law changes are needed, then the compliance date will be the first day of the second calendar quarter beginning after the close of the first regular session of the State legislature that begins after the effective date of the final rule. • Optional provisions (such as Paternity-only Limited Service [§ 302.33(a)(6)], Case closure criteria [§ 303.11(b)], Review and adjustment of child support orders [§  303.8 (b)(2)], Availability and rate of Federal financial participation [§ 304.20], and Topic 2 Revisions): There is no specific compliance date for optional provisions. • Payments to the family [§ 302.38], Enforcement of support obligations [§  303.6(c)( 4)], and Securing and enforcing medical support obligations [§ 303.31]: If State law revisions are needed, the compliance date is the first day of the second calendar quarter beginning after the close of the first regular session of the State legislature that begins after the effective date of the regulation. If State law revisions are not needed, the compliance date is 60 days after publication of the final rule. • Collection and disbursement of support payments by the IV-D agency [§ 302.32], Required State laws [§ 302.70], Procedures for income withholding [§ 303.100], Expenditures for which Federal financial participation is not available [§ 304.23], and Topic 3 revisions: The compliance date is the same as the effective date for the regulation since these revisions reflect existing requirements.
      42 CFR Part 433