Yes. In Retkiyan v. Mlotkiewicz, the Honorable Judge Jones of the Superior Court of New Jersey, Family Part of Ocean County reviewed the legal obligation of divorced parents to contribute toward the ongoing unreimbursed and uncovered health related expenses for their minor children. Judge Jones advised lawyers and parents alike that: (1) in divorce practice, there is a general need for a system to effectuate the timely, orderly, and consistent payment of uncovered medical expenses for the children of divorced parents. If the divorced or divorcing parents have not set up such a system themselves in a consent order or matrimonial settlement agreement, the Family Part court can establish a specific system for the parents to follow in handling the future payment of ongoing, unreimbursed and uncovered health care bills; and (2) as the probation department collects child support in most circumstances, and contribution towards a child’s medical bills is a type of child support, when a custodial parent acquires an order quantifying the past medical arrears of a non-custodial parent in a specific dollar amount, the Family Part many add the same arrear to any existing child support arrears under a probation account. Moreover, the same increased arrears are collectible by the probation department under a specified court mandated repayment schedule.

Karen Ryan and John Mlotkiewicz got divorced in 2009. As the time of this present litigation, the both shared joint legal custody of their four children. Karen was the designated primary residential custodian. John was obligated to pay Karen $ 328 a week in child support for the benefit of the children. The parents had a deeply litigious history, and were currently contesting the payment of their children’s past and future uncovered health related expenses. According to the explicit terms of a previous consent order, the parents should have divided such expenses equally, on a 50-50 basis. Still, there was no exact system in place to actually effectuate their agreement. At the same time, the communication between the parents was challenging and only getting worse.

Presently, Karen alleged that John payed his share of the children’s medical costs very rarely, and had accrued medical arrears in the amount of $ 4,156.71. As a result, she filed a motion in aid of litigant’s rights to enforce his compliance, and to get his contribution toward the payment of their children’s past medical bills. Conversely, John did not necessarily challenge the amount of the medical bills, but did challenge the necessity of some of the costs, like chiropractic expenses for injuries from sports. Judge Jones noted, however, that John failed to provide any proof that those services were not medically necessary or unreasonable.

Judge Jones stated that the bigger concern, however, was not the past bills, but the anticipated future uncovered medical bills. Even though the parents initially agreed to split the ongoing uncovered medical expenses of their children equally, in reality their agreement lacked specific terms for a functional and detailed system to follow for the processing and payment of the same bills in an efficient and timely manner. The judge found that in light of the litigious history between the parents, they needed such a system, because the continued absence of such a system was not only the reason they were presently in court, but almost guaranteed future litigation between the parents as future medical costs were sure to accrue. As such, the Family Part of Ocean County found that it was in the children’s best interest, under the parens patriae jurisdiction, to establish a specific system for the parents to follow for the ongoing processing, review, and payment of the children’s future uncovered health related costs.

According to New Jersey law, child support is a continuous obligation of both parents, who are equally responsible to share in the expenses associated with taking care of an unemancipated child. This duty does not merely extend to basic child support. A financially solvent parent, generally, must also contribute toward their child’s ongoing uncovered medical expenses. New Jersey’s Child Support Guidelines specifically address a parent’s duty to pay for both non-recurring and recurring health care costs. Recurring and predictable costs over $ 250 a year are not already included in a basic child support figure, and as such, must be added to the ordered child support obligation.

Future health care costs over $ 250, that are neither recurring nor predictable, are not included in basic child support figures, and practically cannot be added to basic support in a way increasing a set weekly support obligation. This is because these expenses are, by their very definition, “unpredictable.” Such costs can vary in frequency and costs, depending on each child’s specific healthcare needs at any given time in the future. According to Appendix IX-A to Rule 5:6A, note 9(c) of the Child Support Guidelines, such a non-recurring expense should be shared by both parents in proportion to their relative incomes, as the costs are incurred. Furthermore, because these costs are not included in the basic child support award, the procedure for sharing the expenses should be enumerated in the general language of the child support order.

Judge Jones explained that in the present case, while both parents were required to contribute towards their children’s uncovered medical expenses, there was no procedure in place to effectuate the same, and avoid a cycle of litigation in court. To solve the problem of ongoing medical contributions, the Family Part of Ocean County supplemented the parent’s consent order with a brand new order that established a detailed and specific system for the payment of ongoing uncovered medical expenses. As part of the order, the parents were required to reasonably communicate about issues relating to their children’s health. This included advance notice of any health related appointment, except in the case of emergencies. Moreover, such notice was required to be in writing, which included text messages and e-mail.

The supplemental order further stipulated that the residential custodian, in this case Karen, would be responsible for providing the non-residential parent, John, with a documented bi-monthly accounting of all the health related expenses paid by the custodial parent, every two months. Furthermore, the custodial parent must attach a one-page cover page listing each expense, the provider, and amount paid to the provider, in addition to an itemized calculation of the reimbursement due from the non-custodial parent. The attached documentation would include the invoice, proof of date and amount of payment by cancelled check, credit card statement, or cash receipt. The non-custodial parent, John, would be required to remit payment to the custodial parent within 30 days of receiving the accounting and invoice. Likewise, if the non-custodial parent incurs any uncovered medical expenses for the children during parenting time, the reverse of the above arrangement would be applicable.

In the event one parent objects to the necessity or reasonableness of the medical services, the objecting parent must file a motion with the court within thirty days to address the issue. The objecting parent may not just refuse to pay a disputed medical bill without bringing the matter in front of the court to explain and justify why they object. If the court finds that the parent took an unreasonable position about a medical bill, the court has the discretion to implement sanctions or other equitable relief.

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