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From Health Law Daily, November 17, 2014

HHS modifies child support enforcement rules in Proposed rule

By Michelle Oxman, JD

CMS and the Administration for Children and Families have released a Proposed rule that would clarify the responsibilities of states concerning their administration of their child support enforcement (CSE) programs and make changes to the requirements for medical child support. Among other changes, the Proposed rule would eliminate the bar to consideration of coverage through Medicaid or the Children’s Health Insurance Program (CHIP) as an acceptable means to cover a child who is the subject of a support order (Proposed rule, 79 FR 68548, November 17, 2014).

Medicaid-related issues. Federal regulations have prohibited consideration of children’s eligibility for Medicaid or CHIP when ordering parents to provide health coverage for them. Because many parents whose children are eligible for Medicaid or CHIP have no access to employer-sponsored health insurance, regardless of the cost, the agency would change its policy to allow the use of public or private coverage rather than insisting on private coverage.

CSE programs are required to recover support from noncustodial parents when children receive Medicaid or CHIP. The proposed rule would give CSE programs greater discretion to choose not to pursue cases where there is little or no likelihood of recovery from the noncustodial parent. The regulations would direct agencies to consider the subsistence needs of the noncustodial parent and discourage the imputing of income, especially when the noncustodial parent is incarcerated for more than 90 days. In addition, CSE will no longer pursue Medicaid-only support cases when the health care services have been furnished by or under contract with the Indian Health Service (IHS). This change would eliminate an inequity in that only parents whose children received Medicaid have been required to repay the cost of services received through IHS.

MainStory: TopStory MedicaidPaymentNews CMSNews

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