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Medical Enforcement Only Status Overview

After a medical support order has been entered, Child Support Services (CSS) may update a case to Medical Enforcement Only (MEO) based upon a request from the custodial person unless:

  • Assigned court-ordered child support and/or medical support is owed under OAC 340:25-5-117;
  • The child(ren) is in a deprived or delinquent juvenile court action; or
  • The custodial person is a child care subsidy recipient.

If the child support order contains an order for medical insurance that is in effect or it provides for cash medical support in the amount of $0.00 the case may be updated to MEO on request of the custodial person. However, if the order provides for cash medical support in an amount greater than $0.00 and non-TANF Medicaid services are being provided the case must remain full service.

If there are multiple custodians on the case, a case could be both MEO and full service. For example, if there are two children on the case and each one resides with a different custodian who has applied for non-TANF Medicaid only, each custodian has the option to request MEO or full service. If the first custodian requests full service and the second custodian requests MEO, any child support balances related to the second custodian would not be enforced. Full services would be provided to the first custodian.

The purpose behind MEO status is to provide a way for custodians to cooperate with CSS for the purposes of Medicaid eligibility, as is required by statute, but to allow them to do so without having to pursue a full child support case in situations where the parties have reached agreeable arrangements between themselves. As such, MEO is designed to be used only in situations where the only state benefit being expended is Medicaid(SoonerCare).Additionally, MEO may be used in situations where a customer requests case closure, but we are unable to close the case because of SoonerCare benefits. If the conditions for MEO are met in those situations, it might be a good option for the case.

Please remember that child-only SoonerCare cases on which an order has been established cannot be closed at the CP’s request, but should only be closed with either closure code 16(Non-TANF, CP Unreachable for 60 Days)or closure code 17 (Non-TANF, Customer Uncooperative). These closure codes will only work if the CP is not active on SoonerCare. If the CP is active on SoonerCare, the only way to close the case is for the CP to be removed from SoonerCare through the non-cooperation process and then close the case using closure code 17.See “How to Close Child Only Medical Cases” for more information.

The point of greatest confusion appears to be that many are under the impression that a case cannot be placed into MEO status if the custodial person (CP) is receiving SoonerCare as well. This is not correct. A case can be placed in MEO status if the CP is active on SoonerCare benefits. There is nothing in our policies that prevents a case from being placed in MEO status if the CP is included in the SoonerCare benefits. If SoonerCare is active and there is a cash medical order for $0 or if insurance is ordered and being carried, the case is eligible to be placed into MEO, even if the CP is active on the SoonerCare as well.