Idaho Admin. Code r. 16.03.01.291 - MEDICAL SUPPORT COOPERATION

A Medicaid participant responsible for assigning their rights to medical support must cooperate to identify and locate the noncustodial parent, establish paternity, and establish, modify, and enforce a medical support order.

01. Cooperation Defined. Cooperation includes providing all information to identify and locate the non-custodial parent and identify other liable third party-payers. The participant must provide the first and last name of the non-custodial parent, and at least two (2) of the following pieces of information about the non-custodial parent:
a. Birth-date;
b. SSN;
c. Current address;
d. Current phone number;
e. Current employer;
f. Make, model, and license number of any motor vehicle owned by the non-custodial parent; or
g. Names, phone numbers, and addresses of the parents of the non-custodial parent.
02. Good Cause Defined. The participant may claim good cause for failure to cooperate in securing medical support for a minor child. Good cause is limited to the following:
a. Proof the child was conceived because of incest or rape;
b. Proof the child's non-custodial parent may inflict physical or emotional harm to the participant, the child, the custodial parent, or the caretaker relative;
c. A credible explanation is provided showing the participant cannot provide the minimum information regarding the non-custodial parent; or
d. A participant who has good cause for not cooperating under Subsection 291.03.b of this rule.
03. Conditions for Non-Denial of Medicaid. Medicaid cannot be denied for individuals who meet one (1) of the following conditions:
a. A child or unmarried minor child who cannot legally assign their rights to medical support; or
b. A pregnant woman whose income is at or below the FPG, and who does not cooperate in establishing paternity and obtaining medical support from, or derived from, the father of the unborn child.

Notes

Idaho Admin. Code r. 16.03.01.291
Effective July 1, 2024

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