PARTIAL APPROVAL OF UNDUE HARDSHIP WAIVER REQUEST NOTICE TEXT-LTC ASSET TRANSFERS
When an undue hardship is partially approved for an expired penalty period, the following text and citations should be printed on the manual notice sent to the individual in the LTC facility as well as all involved parties, informing them that the undue hardship waiver was partially granted:
You requested an undue hardship waiver which we are now granting. Effective __________ you qualify for payment of services in an LTC facility, but you must make a monthly payment towards your cost of care. Details of this monthly payment towards your cost of care are found in the LTC section.
Citations: 42 U.S.C. § 1396p(c),
55 Pa. Code 178.104b, 181.452, 181.453 and 255.4
PARTIAL APPROVAL OF UNDUE HARDSHIP WAIVER REQUEST NOTICE TEXT-HCBS ASSET TRANSFERS
When an undue hardship is partially approved for an expired penalty period, the following text and citations should be printed on the manual notice sent to the individual requesting payment of HCBS as well as all involved parties, informing them that the undue hardship waiver was partially granted:
You requested an undue hardship waiver which we are now granting. Effective _________ you qualify for payment of HCBS in the __________ waiver. The service provider/coordinator will notify you when your HCBS will begin.
Citations: 42 U.S.C. § 1396p(c),1396p(f); 62 P.S. § 441.8;
55 Pa. Code 178.104b and 255.4
Updated March 14, 2023, replacing May 2, 2016