An institutional care contract is a contract between an individual and a facility that gives the individual the right to receive care for free or at a reduced cost at the facility. It is also called a maintenance agreement. 55 Pa. Code § 161.73(a)
If an individual has an institutional care contract with a facility, the CAO must take the following actions: 55 Pa. Code § 161.83(a)
1. Decide whether the individual is eligible for MA. Do not consider the institutional care contract as a resource or income.
2. If the individual is eligible, authorize MA.
3. Send a photocopy of the institutional care agreement and a CIS or eCIS printout to the following address:
Bureau of Program Integrity
Division of Third Party Liability
P.O. Box 8486
Harrisburg, PA 17105
The Third Party Liability (TPL) Section must review the institutional care contract to decide whether it is a third-party resource. If the contract is considered a resource, the TPL unit must enter the information into the TPL master file.
Updated February 14, 2012, Replacing February 8, 2002