The CAO must authorize an OTI to correct an underpayment. To be eligible for a corrective payment, the person must be:
a current TANF recipient;
a person who would have been a current recipient if the underpayment had not occurred; or
a former TANF recipient.
55 Pa. Code § 227.24(d)(1)(ii)(A)
The person is eligible for a corrective payment if one of the following conditions is met:
The person caused the error or delay.
Example: The CAO discovers that a client was eligible for a transportation allowance to attend a training program but the person did not report the need because he or she did not realize a special items allowance was available.
Exception: The CAO must not correct an underpayment if a person fails to report timely a change in need or if the CAO acts timely on a verified change in need.
Example: Ms. Robins receives TANF for herself and three children. She works 30 hours per week. On November 10, her hours are reduced to 25 hours per week. The first check that shows this change in hours is received on November 21. If Ms. Robins reports and verifies the decrease in earned income, the IMCW will increase the cash benefit with the first payment date that can be met. However, Ms. Robins fails to report and verify this change until December 15. The IMCW adjusts the cash benefit effective with the first payment date after December 15 that can be met with proper notice. The IMCW is not required to issue a supplemental payment.
NOTE: The addition of a person to a budget cannot be retroactive to a date before the completion of his or her PA 600, regardless of when the need began.
The underpayment was caused by agency error or delay.
Examples:
The CAO incorrectly computed gross income for a prior payment month.
A person reports and verifies an increase in income. The CAO enters incorrect information in eCIS, causing a case closure. The person reapplies. The CAO discovers that the income was entered incorrectly and the budget should not have been closed. The CAO reviews eligibility for a corrective payment back to the date of closure.
NOTE: An agency error has not occurred if the CAO overestimated or underestimated anticipated income if the estimate was reasonable. A reasonable estimate is based on verified information provided by the person and/or the source of the income.
A person reports and verifies an increase in income. The CAO estimates earnings based on the one pay stub provided. The estimated income results in case closure. The person reapplies. The CAO discovers that the person only received two pays from the employer. There is no underpayment because the estimate was reasonable.
NOTE: An agency delay has not occurred if the CAO acted timely on a verified change in need.
A person’s wages decrease in May. The person does not report the decrease in wages until the end of June. The CAO acts timely on the verified change to increase the benefit by the next payment date that can be met. There is no underpayment for this case.
The error or delay was caused by a third party and the person verifies the cause upon CAO request.
Example: The person was unable to receive a deduction from earned income for dependent care because the dependent care provider failed to provide proof of payment.
A fair hearing decision rules that a person was underpaid.
Example: The CAO denies TANF to a recipient who has failed to provide verification for eligibility. The hearing decision orders the CAO to provide TANF based on information provided at the hearing. There is no federally required time limit on the retroactive period that can be covered when correcting an underpayment for a TANF case.
The OTI for a corrective payment may be issued from the county emergency fund if the budget group has an immediate need for cash, or by Central Office issuance. See Section 180.4 for requirements for using the county emergency fund.
Use one of the following reason codes to issue a corrective payment:
105—due to client error when the case is currently active
106—resulting from administrative error or delay
107—resulting from a hearing decision
110—for an earlier period of assistance to a client who is reapplying
199—a court order
Process an OTI for a corrective payment within 30 days. A corrective payment is delayed if more than 60 days have gone by since the date the budget group was underpaid. Reason codes 105, 106, 107, 110, and 199 will allow issuance of an OTI beyond the 30-day limit. See Section 181.3 for authorizing an OTI that is delayed more than 60 days.
If the budget group has a cash underpayment and overpayment during the same period, authorize a corrective payment, and refer the overpayment to OIG. Advise OIG of any corrective payments on the Overpayment Referral (OIG 189).
Make corrective payments for the following agency errors:
During the grace period, the CAO did not act on the notification from the caretaker or relative, another responsible person, the provider, or a baby alert from Headquarters.
The CAO did not process the MA 112 or an MA application form when it came into the CAO within the grace period, and the mother signed the MA application form certifying the birth.
Example: An MA 112 came into the CAO on May 21 noting that a newborn child's date of birth was April 28. For some reason, no action was taken. The mother called on June 1 to ask when she would receive the benefit increase for her newborn. The mother reported that she was released from the hospital on May 11. Since the MA 112 was received during the grace period, the CAO issues a corrective payment retroactive to the newborn child’s date of birth.
The medical provider failed to send the MA 112 to the CAO in a timely manner, but later billed DHS for the expenses of the newborn child's birth. Make a corrective payment retroactive to the newborn child's date of birth.
55 Pa. Code § 227.24(d)(1)(ii)(A)(IV)
There is no corrective payment for an administrative error if the hospital did not process the MA 112 because they billed a third party. If the hospital does not provide an MA 112 or does not provide one timely, authorize MA retroactively to the date of birth when notified of the birth of the child.
Example: The hospital did not send an MA 112 or otherwise notify the CAO until August 1 for a newborn child born on May 1 because they had billed a third-party insurance company. A corrective payment is not processed, because an administrative error did not occur.
Reissued September 21, 2012, replacing January 31, 2012