Operations Memorandum - Cash Assistance
OPS000805

8/29/00
SUBJECT: Reimbursement Form
TO: CAO Executive Directors
FROM: Raymond E. Schlechter, Director Bureau of Operations

Purpose

To remind staff of the proper distribution of the Reimbursement Referral Form (OIG 173-S).

Background/Discussion

Per Supplemental Handbook (SH) Chapter 915.711, Preparation and Submission of the OIG 173-S, distribution of the OIG 173-S is as follows:

For reimbursement codes 04 (personal injury) and 08 (worker’s compensation), the OIG 173-S is to be submitted to the DPW TPL-Casualty Unit. For all other reimbursement codes, the OIG 173-S should be forwarded to the Office of Inspector General (OIG) Reimbursement Recovery Section. Reimbursement codes are listed on the OIG 173-S in Section 1, Item #10 titled, RE Code.

Unfortunately, there has been some confusion concerning the proper referral process, and the TPL-Casualty Unit has received numerous referrals for delayed benefits such as Social Security and SSI. Also, the OIG has received referrals for personal injury claims and worker’s compensation, which should have been forwarded to the TPL Unit. This has resulted in the delayed processing of referrals and claims and a considerable backlog of cases which the OIG and TPL-Casualty Unit are currently clearing.

To correct this problem, please review proper referral procedures with staff and effective immediately forward only Reimbursement Reason codes 04 (personal injury) and 08 (worker’s compensation) per Item #10 on the OIG 173-S to the TPL-Casualty Unit. Please forward all other reimbursement referrals to the OIG.

Another processing problem has been that the Agreement and Authorization to Pay Claim (FAIR 176-K) and Agreement and Authorization to Pay Medical Assistance Claim) FAIR 176-KM are being forwarded to the TPL Unit without the OIG 173-S attached. Please have the proper reimbursement forms signed and attached to the 173-S when submitted. If the FAIR 176-K and KM cannot be forwarded at the same time as the OIG 173-S, please attach a copy of the CAO file copy (OIG 173-S) to the reimbursement forms. This will expedite the processing of the forms and claims.

Next Steps

  1. Please review SH Chapter 915.7 with appropriate staff.

  2. Please contact your Area Manager with any questions.

  3. This memorandum becomes obsolete upon completion of
    the above steps.