Medicaid birth cost recovery.

ORIGINAL
House
ENGROSSED
Bill No
.
HB0086

ENROLLED ACT NO. 59,

HOUSE OF REPRESENTATIVES

SIXTY-FOURTH LEGISLATURE OF THE STATE OF WYOMING
2018 Budget Session

AN ACT relating to welfare; requiring the department of family services to recover birth costs paid by medical assistance from specified persons; providing procedures for the calculation and collection of birth costs; creating accounts; providing rulemaking authority; requiring specified persons to cooperate with a paternity determination as a condition of eligibility for medical assistance; making conforming amendments; specifying applicability; and providing for effective dates.

Be It Enacted by the Legislature of the State of Wyoming:

Section
1
.

W.S.

14
‑
2
‑
1001 through 14
‑
2
‑
1008

and 42
‑
4
‑
122
are
created to read:

ARTICLE 1
0
MEDICAID FAIRNESS ACT

14
‑
2
‑
1001
.

Short title.

This article
may be cited as the
"
Medicaid
Fairness Act
.
"

14
‑
2
‑
1002
.

Definitions.

(a)

As used in this article
:

(
i
)

"
Birth cost
"
mean
s all expenses relating t
o prenatal care, delivery of a
child and any other costs which are directly connected to a pregnancy
and paid by medical assistance
;

(ii)

"
Department
"
means the department of family services created pursuant to W.S. 9
‑
2
‑
2101
;

(ii
i
)

"
Federal poverty level
"
means the federal poverty guideline updated annually in the federal register by the United States department of health and human services
;

(
iv
)

"
Medical assistance
"

means as defined
in W.S. 42
‑
4
‑
102(a)(ii).

14
‑
2
‑
1003
.

B
irth cost recovery

‑

medical assistance
.

(a)

Not
more
than sixty (60) days after a
n unmarried
recipient of medical assistance gives birth to a child, the department of health shall notify the
department of family services

of the
actual amount of birth
cost
s
paid by medical assistance.

(b)

Upon receiving notice pursuant to subsection (a)
of this section
, the
department
shall determine whether

the
paternity
of the child
has been established.

(c)

Consistent with W.S. 42
‑
4
‑
106(b), i
f paternity has been established based on an acknowledgment made pursuant to W.S. 14
‑
2
‑
601,
the
department
shall
, in writing,

request the father to pay th
e
amount
of
birth
costs
established
p
ursuant to W.S. 14
‑
2
‑
1004
.

(d)

Within ninety (90) days of a request made pursuant to subsection (c) of this section, i
f
the father has not made
full
payment
or has not made arrangements for
full
payment to the satisfaction of the
department
,
the
department
shall commence a civil action in accordance with W.S. 14
‑
2
‑
204 to recover
the amount
of
birth
costs
established
p
ursuant to W.S. 14
‑
2
‑
1004
.

(e
)

I
f paternity has not been established,
the
department
, in cooperation with the mother
of the child
, shall use

any
means authorized by law to determine
the
paternity
of the child
, subject to W.S. 42
‑
4
‑
122(b)(ii).

(f
)

Consistent with W.S. 42
‑
4
‑
106(b),

i
f the father of the child is identified by the
department
pursuant to subsection (e) of this section
, the
department
shall bring a civil
action
to
a
djudicate paternity
and
r
ecover the
amount
of
birth
costs
established
pursuant to

W
.S. 42
‑
4
‑
1004

from the father
, in the m
anner set forth in W.S. 14
‑
2
‑
822
.

(g
)

The department
shall not
take any of the actions set forth in this section
on or
after
the fifth birthday of the
child.

14
‑
2
‑
1004
.

B
irth cost recovery calculation

‑

medical assistance.

(a)

Before requiring the payment of any amount
of birth costs
under W.S. 14
‑
2
‑
1003
,
the department
shall require the father to provide satisfactory proof of income. If the father
does not
provide satisfactory proof of income, or
if
the
department
is unable to determine the father
'
s income u
sing
any means aut
horized by law,
a rebuttable presumption shall exist
that the fathe
r
'
s income is greater than four
hundred percent (400%) of the federal poverty level.

(b
)

A
fter notification
of birth costs

pursuant to W.S. 14
‑
2
‑
1003(a),
t
he department
shall calculate the
amount

of birth costs
that
are

recoverable
from the father
in the following manner
, subject to subsection (d) of this section
:

(
i
)

For
a father earning less than two
hundred percent (200%) of the
federal poverty level
, zero percent (0%) of the
birth

costs
;

(ii)

For a father earning two
hundred percent (200%)
or greater,
but less than two
hundred fifty percent (2
50%) of the federal poverty level
,
ten
percent
(10
%) of the
birth

costs
;

(iii)

For a father earning two
hundred fifty percent (250%) or greater, but less than three hundred percent (300
%) of the federal poverty level
,
twenty percent (2
0%) of the
birth

costs
;

(iv)

For a father earning three
hundred percent (300%)
or greater, but less than three
hundred fifty percent (350
%) of the federal poverty level
, thirty percent (3
0%) of the
birth

costs
;

(
v)

For a father earning three
hundred fifty percent (350%) or greater, but less than four hundred percent (400
%) of the federal poverty level
,
forty
percent (
4
0
%) of the
birth

costs
;

(v
i
)

For a father earning four hundred percent (400
%) of the federal poverty level
or greater, fifty percent (5
0%) of the
birth

costs.

(c)

The department may assess a fee, in addition to any recoverable
birth
costs under
subsection (b) of
this section, which equals the average expenses incurred by the department on a per case basis for the administration of this
article
and W.S. 42
‑
4
‑
122, plus any attorney
'
s fees, if applicable. No fee
or attorney's fees
shall be assessed
against a father who meets the criteria of paragraph
(b)
(
i
) of this section.

(d)

The
total
amount recoverable by the department
under

this section, including any fee
or attorney
'
s fees assessed pursuant to subsection (c) of this section
, shall not exceed
the average
birth
cost

paid by medical assistance
in
this state, as established by
rule promul
gated pursuant to W.S. 14
‑
2
‑
1008
.

14
‑
2
‑
1005
.

B
irth cost recovery allocation

‑

medical assistance
.

(a)

Except as otherwise provided in subsection
s
(c) and (d) of this section
, a
ny amount recovered by
the department
pursuant to
W.S. 14
‑
2
‑
1003
(c), (d) or (f) shall be
remitted
to
the department of health.

(b)

Except as otherwise provided in subsections (c) and (d) of this section, a
ny amount
recovered by the department
pursuant
to
W.S.
20
‑
2
‑
401(f)
shall be:

(
i
)

R
ecovered in the manner set forth i
n W.S. 20
‑
6
‑
101 through 20
‑
6
‑
222
;
and

(ii)

R
emitted by
the

department

to the department of health.

(c)

The department
of health
shall

remit

to the federal government
any amount
collected under this article and
required to be reimbursed
pursuant to 42 U.S.C.
1396k(b)
.

(d)

The
department
may
, on a
quarterly basis, remit:

(
i
)

Forty percent (40
%) of the total amount of birth costs recovered pursuant to W.S. 14
‑
2
‑
1003(c), (d) and (f) and 20
‑
2
‑
401(f), less any reimbursements made to the federal government pursuant to subsection (c) of this section, to the birth cost recovery incentive account created pursuant to W.S. 14
‑
2
‑
1006(a).

(ii)

Any fee
or attorney's fee
assessed by the department pursuant to W.S. 14
‑
2
‑
1004
(c)
to
the birth cost recovery administration
account
created pursuant to W.S. 14
‑
2
‑
1006(b).

14
‑
2
‑
1006
.

Birth cost recovery accounts.

(a)

There is created the birth cost recovery incentive account. Funds remitted to the account
pursuant to W.S. 14
‑
2
‑
1005(d)(
i
)
shall
be used by the department for
any services or programs relating to infants or mothers
. The account may be divided into subaccounts for purposes of administrative management. Funds in the account are continuously appropriated and shall not lapse at the end of any fiscal period.

(b)

There is created the birth cost recovery administration account. Funds remitted to the account pursuant to W
.S. 14
‑
2
‑
1005(d
)
(ii)
shall be used
by the department to offset the costs of
the administration of this article and W.S. 42
‑
4
‑
122. The account may be divided into subaccounts for purposes of administrative management. Funds in the account are continuously appropriated and shall not lapse at the end of any fiscal period.

14
‑
2
‑
1007
.

Best interests of a child.

The department shall not take any action authorized by this article and W.S. 42
‑
4
‑
122 if the department determines that the action would not be in the best interests of a child.

14
‑
2
‑
1008
.

Adoption
of rules.

The
department of family services

and the department of health, in consultation with each other,
shall
each

promulgate
rules to
carry out
the provisions of
t
his a
rticle
and W.S. 42
‑
4
‑
122
.

42
‑
4
‑
122
.

Cooperation with paternity determination.

(a)

Except as otherwise provided in subsection (b)

of this section
, as a condition of eligibility, or continuing eligibility, for medical a
ssistance under this chapter, a person
who receives medical assistance shall cooperate in good faith with
the department
to:

(
i
)

Establish
the
paternity of a child, including any proceeding to adjudicate parentage
that
is held pursuant to W.S. 14
‑
2
‑
801 through 14
‑
2
‑
823;

(ii)

Obtain
a child support obligation payment
or other payments or property to which
the
state may have a claim
, including
recovery

of birth
cost
s
paid by medical assistance
pursuant to
W.S. 14
‑
2
‑
1001 through 14
‑
2
‑
1008
.

(b)

The following
persons
are not required to cooperate with
the department
pursuant to subsection (a)
of this section
:

(
i
)

A
person
who is pregnant, or who has been pregnant within the preceding sixty (60) days;

(ii)

A
person
who has good cause
to not cooperate with the department, as determined by

rule promulgated
pursuant to W.S. 14
‑
2
‑
1008
.

Section 2
.

W.S.
14
‑
2
‑
822
by creating
a
new
subsection (g)
,
20
‑
2
‑
401
by creating
new
subsection
s
(f)

and (g)

and 42
‑
1
‑
102(a)(intro)
are amended to read:

14
‑
2
‑
822
.

Order adjudicating parentage.

(g)

Upon a sufficient showing by the
department of family services
that
birth costs
were
paid
by medical assistance
within the preceding five (5) years
, the court shall include a requirement in an order adjudicating parentage that the father pay
birth costs

to the
department
in the manner
set forth in
W.S.
14
‑
2
‑
1004
.
Failure of the department to
make a sufficient showing
under this subsection shall not preclude the department from
subsequently
seeking
recovery
in
any other manner authorized by law
.

20
‑
2
‑
401
.

Medical support to be included as part of child support order.

(f)

In any action to establish or mod
ify a child support obligation and upon a sufficient showing by the department of family services that
birth costs
were paid by medical assistance within the preceding five (5) years,
the court shall also order that the father pay
birth costs
to the department in the manner set forth in W.S.
14
‑
2
‑
1001 through 14
‑
2
‑
1008
.
Failure of the department to
make a sufficient showing
under this subsection shall not preclude the department from
subsequently
seeking
recovery
in
any other manner authorized by law
.

(g)

If the department of family services has previously attempted to recover
birth
costs pursuant to
W.S.
14
‑
2
‑
1001 through 14
‑
2
‑
100
8
, the court is not required to
issue
the order described in subsection (f)
of this section
.

42
‑
1
‑
102
.

Conflict with federal laws.

(a)

If any provision of this title

or

W.S. 14
‑
2
‑
1001 through 14
‑
2
‑
1008
is found to be in conflict with federal law or to come in conflict with federal law due to new federal enactments, the department shall:

Section 3
.

On or before July
1, 2018,
t
he department of family services and
the department of health, in consultation with each other,
shall each
promulgate
rules required by section
1
of this act, provided that these
rules shall not take effect
until
July 1, 2018.

Section 4
.

This act applies to
the costs of
the birth of any child
by paid medical assistance
on or after July 1, 2018.

Section 5
.

(a)

Except as otherwise provided in subsection (b) of this section, thi
s act is effective July 1, 2018.

(b)

Section 3 of this act is effective immediately
upon completion of all acts necessary for a bill to become law as provided by Article 4, Section 8 of the Wyoming Constitution
.

(END)

Speaker of the House

President of the Senate

Governor

TIME APPROVED: _________

DATE APPROVED: _________

I hereby certify that this act originated in the
House
.

Chief Clerk

1