476.1 General Policy

PMN 21168476, Signature Requirements for Long-Term Care (LTC) and Home and Community-Based Services (HCBS) Renewals, November 1, 2022

PMN 18887476, Proper recording in eCIS of Long Term Care (LTC) and Home and Community Based Services (HCBS) Provider information for Renewals, Revised February 19, 2019

 

A renewal is a periodic review of MA LTC to decide if the recipient still qualifies for MA LTC.  A renewal may be complete or partial.

A complete renewal of eligibility for LTC facility services is required every year.  A partial renewal is required based on the circumstances of the case.

62 P.S. § 442.3

 

NOTE:  When authorizing MA LTC, CIS/ eCIS will establish a renewal due date.  The IMCW should change the date displayed in CIS/eCIS or set alerts as needed.  CIS/eCIS will allow a maximum of one year for all MA LTC categories.

 

The CAO will not require a renewal (complete or partial) for an individual who is receiving a Supplemental Security Income (SSI) personal needs allowance while living in the LTC facility.  These individuals are category A, J, or M.  The Social Security Administration (SSA) is responsible for reviewing financial eligibility and acting on changes in the individual' s income and resources.

 

The individual or his representative must provide information needed for a complete or partial renewal.  The representative may be a relative, a friend, a representative of the long term care facility, or any other responsible person acting on behalf of the individual.  An application form,  PA600L is required for a complete renewal. An application is not required for a partial renewal.     

   55 Pa. Code § 133.73

  55 Pa. Code § 133.84

     

   

Updated August 26, 2019; Replacing April 23, 2018