Department of Health and Human Services

Office of Inspector General -- AUDIT

"Review to Increase the Number of Non-Custodial Parents Providing Medical Support To Their Children and Reduce Medicaid Costs in Texas," (A-06-02-00053)

June 20, 2003

Complete Text of Report is available in PDF format (940 kb). Copies can also be obtained by contacting the Office of Public Affairs at 202-619-1343.


The objective of this review was to identify the number of children who received Medicaid benefits from Texas, during the period June 1, 2001 through May 31, 2002, because their non-custodial parent (NCP) could not provide court ordered medical support because it was not available or too costly.  We estimate 86,011 children received Medicaid benefits during the period June 1, 2001 through May 31, 2002 because their NCP could not provide court ordered medical support.  Of these 86,011 children, we estimate that 60,271 had NCPs who could, however, have been able to contribute $16.6 million towards Medicaid costs totaling $36.9 million incurred by the State and Federal Government on behalf of these children.

In 2001, the Texas Legislature strengthened its provisions for health care coverage by requiring the court to order the custodial parent to apply for benefits under either the Medicaid program or the State child health plan if neither parent had access to private health insurance at a reasonable cost.  In addition, the court must order that the NCP contribute cash medical support payments for actual costs of their child's participation in such program.  Court orders written under prior Texas law did not require NCPs to contribute towards Medicaid costs when private health insurance was not available.  We recommended that Texas ensure medical support orders written under prior laws, for children receiving Medicaid benefits, are revised as they come up for modification to require NCPs to contribute towards Medicaid costs paid on behalf of their children.  State IV-D officials agreed with our recommendation.