PM 03-19-03.

Document in the case record when an adult fails to cooperate with medical support requirements.

NOTE: Pregnant women are entitled to Moms and Babies (see WAG 06-09-00).

Deny or stop medical for the noncooperating adult as follows:

Cash Applications

  • Deny medical benefits for the noncooperating adult, and approve cash benefits, if eligible, by entering code 4 in Item 78, Type Benefits.
  • Notice of Decision on Application for Cash, Medical and/or FS (Form 360C) is centrally sent advising the applicant of the person who has not cooperated with medical support rights. Enter code 00 in Item 39 on the correct AIS screen.
  • For a locally issued notice Form 360H, enter code 90 in Item 39. Complete Form 360H entering in the "Ineligible Persons" section the name of the person who has not cooperated with medical support rights.

NOTE: If the noncooperating person is the payee, do not change their status to RPY.

Active Cash Cases

Stop medical benefits for the noncooperating person.

To prevent authorization of medical for a noncooperating adult, complete Form 552 as follows:

Items 2,6 - Complete
Item 3 - Enter 31
Item 33 - Enter 60
Item 44 - Complete
Item 78 - Enter 4 for the noncooperating adult

The system issues Notice of Change (Form 157C) when medical is stopped for a noncooperating adult in an active case. If the noncooperating person is the payee, do not change their status to RPY. When the adult demonstrates cooperation, start medical with the next regular roll action.

NOTE: If the adult also failed to cooperate with DCSE, see WAG 24-04-04.

Medical Applications

  • For cases with adults and children, do not include the noncooperating adult in the case. If the adult is the payee, make them the RPY for the case.
  • Form 360C is centrally sent advising the applicant of the denial of the person who has not cooperated with medical support rights. To send the central notice enter Code 00 in Item 39 on the correct AIS screen.

For a locally issued notice, or if the application is approved through IPACS, enter code 80 in Item 39 to suppress the central notice. Complete and send a Notice of Decision on Application for Medical Assistance-MANG Non Spenddown (Form 458).

  • For adult-only Medical applications, deny the application if there are no other eligible persons.

Active Medical Cases

Stop medical benefits for a noncooperating adult in a family case as outlined above. If the noncooperating person is the payee, make them RPY for the case.

For an adult-only Medical case, cancel the case using TAR 50. Send a locally issued Form 157.