915.1 General Policy

Reimbursement is the repayment of cash benefits received by a client, his spouse, and his unemancipated minor children living with him while awaiting receipt of personal property subject to reimbursement.

55 Pa. Code § 257.22

A client who is liable for reimbursement must, as a condition of eligibility, sign a reimbursement form agreeing to repay cash benefits received for himself, his spouse, and unemancipated minor children.

55 Pa. Code § 257.24(a)(2)(i)(A)

NOTE:  The client’s liability for reimbursement differs from his liability to support his spouse and unemancipated minor children.

55 Pa. Code § 257.21(c)(4)

The Department of Human Services (DHS) is responsible for identifying and referring to the Office of State Inspector General (OSIG) personal property subject to reimbursement.

The OSIG’s responsibility is to compute and collect reimbursement claims except for claims involving third party liability (TPL) resources and medical assistance estate recovery.

 

915.11 Benefits Subject to Reimbursement

Reimbursement is required for:

55 Pa. Code § 257.21(b)

 

 

915.12 Benefits Not Subject to Reimbursement

Reimbursement is not required for:

Exception: MA is reimbursable when a third party is liable for payment of the medical services and from the probate estate of specific MA recipients.

55 Pa. Code § 178.6       62 P.S. 1412

55 Pa. Code § 257.23(b)(6)

 

915.13 Liability

The client is liable for reimbursement beginning with the first assistance check received after:

55 Pa. Code § 257.21(c)(3)

See Appendix A, “Reimbursement Chart” for types of personal property subject to reimbursement.

 

 

 

Reissued March 14, 2019, replacing December 31, 2018