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Library: Policy

340:25-5-169. Establishment of medical enforcement only cases

Revised 9-15-23

(a) Legal authority.  Oklahoma Human Services Child Support Services (CSS) follows Sections 302.33, 302.56, 303.30, and 303.31 of Title 45 of the Code of Federal Regulations (45 C.F.R. §§ 302.33, 302.56, 303.30, and 303.31); Section 6058A of Title 36 of the Oklahoma Statutes (36 O.S. § 6058A); 43 O.S. §§ 112, 118F, 118.2, and 119; and 56 O.S. § 237.

(b) Medical enforcement only (MEO) status.  When a person receiving non-Temporary Assistance for Needy Families (TANF) SoonerCare (Medicaid) notifies CSS that only Title IV-D services related to securing medical support are requested, CSS updates the case as an MEO case and does not provide full child support services per Oklahoma Administrative Code (OAC) 340:25-1-1.2.  • 1 & 2

(c) Services provided on MEO cases.  • 3

(1) CSS establishes paternity, when necessary, and a child support order.  The child support order must include a provision for:

(A) current child support per OAC 340:25-5-178;

(B) support for a prior period per OAC 340:25-5-179.1, when appropriate; and

(C) medical support per OAC 340:25-5-168.

(2) CSS conducts a review of the order per OAC 340:25-5-198.1 and seeks a modified order including a provision for medical support when:

(A) the existing child support order does not include a medical support provision;

(B) insurance is not available for the child(ren); or

(C) a parent or custodial person (CP) claims the available health insurance is not accessible or reasonable in cost.

(d) Exception to MEO status.  CSS opens a full-service case on all the CP's child support cases when CSS receives a non-TANF SoonerCare (Medicaid) referral per OAC 340:25-5-117 from the Oklahoma Health Care Authority and:

(1) assigned court-ordered child support is owed per OAC 340:25-5-117;

(2) the child(ren) is in a deprived or delinquent juvenile court action; or

(3) assigned cash medical support is owed per OAC 340:25-5-117.  • 1 through 4

(e) Enforcement of MEO cases.  When a person receiving non-TANF Medicaid requests MEO services, CSS enforces only the health insurance portion of the child support order through the use of the National Medical Support Notice per OAC 340:25-5-171.  CSS does not enforce the payment of child support or fixed medical support through the Order/Notice to Withhold Income for Child Support or any other enforcement remedy in an MEO case.


Revised 9-15-23

1. Oklahoma Human Services Child Support Services (CSS) staff initially builds all cases as full-service cases.  When a child support order is established, CSS staff indicates that the custodial person (CP) requested a medical enforcement only (MEO) case by updating the Custodial Person Data Update (CCPU) screen on the Oklahoma Support Information System (OSIS) with an MEO begin date.

2. When the child(ren) on the case is on SoonerCare (Medicaid) and health insurance or a cash medical support order of $0 is ordered for the child(ren), CSS staff updates the case as an MEO case at the CP request.

3. CSS staff removes any balances from the case when converting from full-service to MEO case.

4. When CSS establishes a child support order with a medical support provision for cash medical support greater than $0 assigned to the Oklahoma Health Care Authority, per Oklahoma Administrative Code 340:25-5-117, CSS staff must not update the case as an MEO case.

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