[Code of Federal Regulations]
[Title 45, Volume 2]
[Revised as of October 1, 2004]
From the U.S. Government Printing Office via GPO Access
[CITE: 45CFR303.31]

[Page 248-249]
 
                        TITLE 45--PUBLIC WELFARE
 
    CHAPTER III--OFFICE OF CHILD SUPPORT ENFORCEMENT (CHILD SUPPORT 
 
PART 303_STANDARDS FOR PROGRAM OPERATIONS--Table of Contents
 
Sec. 303.31  Securing and enforcing medical support obligations.

    (a) For purposes of this section:
    (1) Health insurance is considered reasonable in cost if it is 
employment-related or other group health insurance, regardless of 
service delivery mechanism.
    (2) Health insurance includes fee for service, health maintenance 
organization, preferred provider organization, and other types of 
coverage under which medical services could be provided to the dependent 
child(ren) of a noncustodial parent.
    (b) With respect to cases for which there is an assignment as 
defined in Sec. 301.1 of this chapter in effect, the IV-D agency shall:
    (1) Unless the custodial parent and child(ren) have satisfactory 
health insurance other than Medicaid, petition the court or 
administrative authority to include health insurance that is available 
to the noncustodial parent at reasonable cost in new or modified court 
or administrative orders for support.
    (2) Petition the court or administrative authority to include 
medical support as required under paragraph (b)(1) of this section 
whether or not--
    (i) Health insurance at reasonable cost is actually available to the 
noncustodial parent at the time the order is entered; or

[[Page 249]]

    (ii) Modification of current coverage to include the child(ren) in 
question is immediately possible.
    (3) Establish written criteria to identify cases not included under 
paragraphs (b)(1) and (b)(2) of this section where there is a high 
potential for obtaining medical support based on--
    (i) Evidence that health insurance may be available to the 
noncustodial parent at a reasonable cost, and
    (ii) Facts, as defined by State law, regulation, procedure, or other 
directive, which are sufficient to warrant modification of the existing 
support order to include health insurance coverage for a dependent 
child(ren).
    (4) Petition the court or administrative authority to modify support 
orders for cases identified in paragraph (b)(3) of this section to 
include medical support in the form of health insurance coverage.
    (5) Provide the custodial parent with information pertaining to the 
health insurance policy which has been secured for the dependent 
child(ren) pursuant to an order obtained under this section.
    (6) Inform the Medicaid agency when a new or modified court or 
administrative order for child support includes medical support and 
provide the information referred to in Sec. 303.30(a) of this part to 
the Medicaid agency when the information is available.
    (7) If health insurance is available to the noncustodial parent at 
reasonable cost and has not been obtained at the time the order is 
entered, take steps to enforce the health insurance coverage required by 
the support order and provide the Medicaid agency with the information 
referred to in Sec. 303.30(a) of this part.
    (8) Periodically communicate with the Medicaid agency to determine 
if there have been lapses in health insurance coverage for Medicaid 
applicants and recipients.
    (9) Request employers and other groups offering health insurance 
coverage that is being enforced by the IV-D agency to notify the IV-D 
agency of lapses in coverage.
    (c) The IV-D agency shall inform an individual who is eligible for 
services under Sec. 302.33 of this chapter that medical support 
enforcement services will be provided and shall provide the services 
specified in paragraph (b) of this section.

(Approved by the Office of Management and Budget under control numbers 
0960-0420 and 0970-0107)

[50 FR 41895, Oct. 15, 1985, as amended at 51 FR 37732, Oct. 24, 1986. 
Redesignated at 54 FR 32312, Aug. 4, 1989, and amended at 56 FR 8004, 
Feb. 26, 1991; 61 FR 67241, Dec. 20, 1996; 64 FR 6250, Feb. 9, 1999; 68 
FR 25304, May 12, 2003]