These procedures apply to the GA-related Medical Assistance Program.
62 P.S. 481.1 established compliance with a summons or bench warrant as an eligibility condition for receipt of GA-related Medical Assistance. Individuals who have been summoned to appear as a defendant at a criminal court proceeding and fail to appear are ineligible for GA-related Medical Assistance (PD and TD).
The same applies for Retroactive GA-related MA:
Retroactive GA-related MA cannot be authorized as eligibility starts with the verified date of compliance with the bench warrant.
NOTE: There may be instances when retroactive GA-related MA could be authorized without the warrant being satisfied, for example death of the applicant. CAO should narrate their decision in these instances in detail.
The procedures below apply to completion of the Criminal History Inquiry Form/GA-Related Medical Assistance Only (PA 1666). These procedures were adopted from the procedures for GA cash assistance found in Section 104.482 of the Cash Assistance Handbook.
The CAO will require each GA-related Medical Assistance applicant or recipient to complete and sign the Criminal History Inquiry Form if a "yes" response is given to the criminal history questions on the PA 600 or PA 600 R. The CAO will then proceed as follows:
If the applicant/recipient answers "no" to question 1, GA-related Medical Assistance may be authorized if the individual is otherwise eligible.
If the applicant/recipient answers "yes" to question 1, he must answer the remaining questions 2 through 5.
An answer that indicates that there is some question about compliance with a summons or bench warrant will require verification. Individuals who claim that they appeared in court must substantiate their claim.
Examples of written verification/documentation include:
Written evidence from the local magistrate's office, court official or law enforcement agency.
Written evidence from another county/state, court official or law enforcement officer.
The CAO can use information from other sources, where available, to verify compliance with these requirements.
The CAO should develop lines of communication, when possible, with other official sources to accomplish the above.
NOTE: The IMCW should always exercise caution when information is received about an individual who has not complied with a summons or bench warrant to appear as a defendant at a criminal court proceeding. In such situations, the appropriate law enforcement agency should be consulted on how to proceed.
If satisfactory documentation is not provided within 30 days of receipt of a completed application or 15 days from the date of a redetermination, the individual is not eligible for retroactive GA-related MA or ongoing GA-related MA.
The IMCW will review the documentation to determine if the individual has complied with a summons or bench warrant. If the documentation does not establish that the individual has complied, the individual is not eligible.
The appropriate notice, using the correct 62 P.S. citation, should be issued to the individual for either failure to comply with a summons or bench warrant or failure to verify compliance. For GA-related Medical Assistance, the citation is 62 P.S. 481.1.
Special "criminal history" reason codes must be used when ineligibility is based exclusively on information obtained through the use of the Criminal History Inquiry.
Updated March 27, 2012, Replacing February 14 , 2012