377.4 Confirming Notice

A budget closed with a confirming notice must be closed on the third day after the action is taken. The CAO must send a confirming notice to the recipient when:

 

 (a) increasing MA benefits or

 

(b) reducing or stopping MA benefits for any of the following reasons:       

  55 Pa. Code § 133.4(c)

          

               The CAO found out certain facts; for example, a CAO caseworker read about a recipient’s death in the newspaper.

 

NOTE:  A notice is not required if the recipient who died lived alone, unless a representative applied for the recipient.

 

 

Example: A: Megan sends a signed PA 1829 requesting their benefits be closed. The worker will close Megan’s MA with a 3-day Confirming Notice to Discontinue using reason code “063 – Voluntary Withdrawal.”

 

Example: B:  Joseph sends a letter indicating their family has moved to Ohio due to new employment. The worker will close the family’s MA with a 3-day Confirming Notice to Discontinue using reason code “064 – Permanent Move Out of State.”

 

NOTE:  The statement will apply to that specific action, not an agreement for other changes.

 

NOTE: A signed statement or PA 1829 must be received to close with a confirming notice if a recipient moves out of state.

 

Example: A woman and her children currently receive MG27. The woman marries and no longer wishes to receive MA. She completes and signs a statement indicating she wants MA to stop for herself and her children.

 

If a signed statement or PA 1829 is NOT received, advanced notice must be sent. See Section 377.3, Advanced Notice.

 

 

               Example: A child was removed from the home by the County Children and Youth Agency (CCYA).

 

 

NOTE: It is important to be very careful before closing a case because of returned mail. The CAO will try to find out the reason the mail was returned. A recipient could be sick or in a hospital and not able to get his or her mail.

 

 

NOTE: The CAO will determine eligibility for payment of services in an LTC facility or HCBS.

Updated July 13, 2023, Replacing February 22, 2021