HAR §17-1705-26. Purpose

This subchapter establishes the procedures for providing notice and processing an individual's good cause claim for refusing to cooperate in obtaining third party payments for medical assistance or securing medical support. [Eff 08/01/94 ] (Auth: HRS §346-14) (Imp: HRS §346-14; 42 C.F.R. §433.147; 45 C.F.R. §§232.40, 232.41, 232.43, 232.47) §17-1705-27 Notice to applicant of right to claim good cause. (a) The department shall notify applicants and recipients of medical assistance of the UNOFFICIAL 1705-10 right to claim good cause as an exception to the cooperation requirement. (b) The applicant or recipient shall be informed in writing that: (1) The potential benefits a child may derive from establishing paternity and securing support and the potential benefits for providing information to assist the department in pursuing third party liability for medical services; (2) By law, cooperation in establishing paternity, securing support, and identifying and providing information to assist the department in pursuing third party liability for medical services is a condition of eligibility; (3) An unexcused refusal to cooperate shall result in loss of medical eligibility for the needy caretaker relative; (4) The individual has the right to claim good cause for refusing to cooperate and if the department determines there is good cause, the individual shall be excused from the cooperation requirements of sections 17-1705-8 and 17-1705-18; and (5) Upon an individual's request or following receipt of a good cause claim, the department shall provide further notice to the individual with additional details concerning a good cause claim. (c) A second notice shall be provided in writing, to applicants or recipients who claim good cause or who notify the department of the individual's intention to claim good cause. (d) The second notice shall be provided promptly, without the applicant or recipient having to reschedule a follow-up appointment. The notice shall inform the individual that: (1) The individual shall be required to provide corroborative evidence of a good cause circumstance as specified in section 17-1705-29, and when requested, shall furnish sufficient information in order to allow the department to investigate the circumstances of the claim; (2) Upon the individual's request, the department will provide reasonable assistance in obtaining the corroborative evidence; UNOFFICIAL 1705-11 (3) The department shall determine whether cooperation would be against the best interest of the child for whom child or medical support would be sought or the individual for whom third party liability for medical services would be sought based on the corroborative evidence supplied; (4) The circumstances under which cooperation shall be determined to be against the best interests of the child or individual; (5) The state Title IVD child support enforcement agency (CSEA) may review the department's findings and basis for a good cause determination and may participate in any administrative hearings concerning the issue of good cause; and (6) CSEA may attempt to establish paternity and collect support and the department may attempt to collect third party information and payment when the department determines that this can be done without risk to the applicant or recipient if done without their participation. [Eff 08/01/94 ] (Auth: HRS §346-24) (Imp: HRS §346-37.1; 42 C.F.R. §§433.147, 433.148; 45 C.F.R. §232.40)