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Process for Good Cause

Legal Authority:

When a custodian applies for SoonerCare (Medicaid), he/she agrees to cooperate with Child Support Services (CSS) to establish and enforce child support and/or medical support. If the custodian fails to cooperate and his/her cooperation is necessary for the next action on the case, CSS reports to the Oklahoma Health Care Authority (OHCA) the custodian is not cooperating.

In some situations the custodian may apply for “Good Cause for Failure to Cooperate.” When a family is receiving Temporary Assistance for Needy Families (TANF), the determination of whether a custodian has “Good Cause” is made by Adult & Family Services (AFS). When a family is receiving non-TANF Medicaid, the “Good Cause” determination is made by CSS and reported to OHCA.

The following is the process CSS uses when a SoonerCare applicant indicates on the application he/she is requesting “Good Cause” or the SoonerCare applicant submits a request to CSS for “Good Cause” for New Referrals and Existing Cases.

  1. Good Cause
    • New Referrals – A referral is received from the OHCA with an indicator showing the custodian has requested “Good Cause.” The case is built by CSS and is marked in the Oklahoma State Information System (OSIS) as “Pending Good Cause Determination.”
    • Existing Cases – The custodian submits a written request for “Good Cause.”
  2. The Good Cause Request Letter (C11) is sent to the custodian.
  3. If the custodian provides adequate documentation to show “Good Cause for Failure to Cooperate” exists, CSS sends the Good Cause Notification Letter (C12) to the custodian and updates OSIS. If the custodian fails to provide adequate documentation, CSS sends the Good Cause Denied Notification Letter (C13) to the custodian and updates OSIS. The case is then pursued as a full service case.