A budget closed with a confirming notice must be closed on the third day after the action is taken. The CAO must send a confirming notice to the recipient when (a) increasing MA benefits or (b) reducing or stopping MA benefits for any of the following reasons: 55 Pa. Code § 133.4(c)
The CAO found out certain facts; for example, a CAO caseworker read about a recipient’s death in the newspaper.
NOTE: A notice is not required if the recipient who died lived alone, unless a representative applied for the recipient.
The CAO received a statement signed by the recipient (or someone acting for the recipient) asking that benefits be reduced or stopped.
NOTE: The statement will apply to that specific action, not an agreement for other changes.
Example: A TC mother gets back together with her husband and signs a note asking the CAO to stop benefits immediately for herself and her children.
The CAO received an official notice that a recipient went into an institution or was removed from the home; for example, a child was removed from the home by the County Children and Youth Agency (CCYA).
The recipient moved out of state.
The CAO doesn’t know where recipient is, and CAO letters, notices, client messages, or ACCESS cards have been returned by the post office.
NOTE: It is important to be very careful before closing a case because of returned mail. The CAO will try to find out the reason the mail was returned. A recipient could be sick or in a hospital and not able to get his or her mail.
The CAO received notice that a recipient entered a Long Term Care (LTC) facility or is medically-eligible for Home and Community-Based services.
NOTE: The CAO will determine eligibility for payment of services in an LTC facility or HCBS.
Updated February 14, 2012, Replacing December 16, 2010