Individuals receiving SSP-Only or SSI and State administered SSP are subject to restitution requirements in Pa. Code Chapter 255.
CAOs may obtain overpayment information from the following:
The Pennsylvania Treasury,
The Social Security Administration (SSA),
CAO review of the eCIS Cash/SNAP/MA Benefits History screen or Cash/SNAP/MA Transcript,
Automated Information Sources (SDX),
PA DHS SSI Documents in OnBase, or
The SSP Central Unit.
NOTE: Overpayments identified by Treasury will be referred in writing to the Department of Human Services, Bureau of Operations and subsequently forwarded to the appropriate CAO Executive Director for action.
Current overpayment policy regarding cash programs is in Cash Assistance Handbook Chapter 170.4. The overpayments pursued by OSIG are based on failure to report required changes. SSI/SSP recipients must report all changes to the SSA. DHS will be made aware of changes via SDX. SSP-Only recipients are required to report address changes only. Refer to Chapter 910, Overpayment Recovery, for guidance on processing overpayments.
Payments made in duplicate due to administrative error and benefits received pending a DHS appeal when the final appeal decision is negative are overpayments. They must be completed using the manual 189 process outlined in Supplemental Handbook Chapter 910, Appendix A.
An underpayment or delayed payment of SSP occurs when one of the following occur:
SSA notifies the CAO of retroactive eligibility at authorization, after suspension, or after a reported change,
CAO Administrative error in determining eligibility or calculating benefits.
The CAO may correct an underpayment resulting from a notification of eligibility or reported change by SSA with a One-Time Issuance (OTI) using Reason Code 105 at any time.
NOTE: If the eligibility segment is missing in eCIS history, the CAO should complete an NCE for the period, and issue the OTI using Reason Code 105.
Retroactive corrective payments due to administrative error is limited to twelve months preceding the month in which the underpayment becomes known to DHS.
Improper denial of assistance is also limited to the twelve months preceding month in which the underpayment first becomes known to the department, but in no case earlier than the date of application.
NOTE: Retroactive corrective payments shall not be considered as income or as a resource in the month in which paid nor in the next following month.
NOTE: In cases which have both an underpayment and an overpayment, the department will offset one against the other in correcting the payment.
Example: The CAO received an Exchange 6 hit for Bernice on 7/1/21. When they reviewed Exchange 6, they discovered that Bernice is in C01 pay status. Bernice was initially denied SSI after applying on 3/1/17, and appealing. Bernice's appeal had a positive decision, and SSA authorized Bernice's SSI beginning 4/1/17. This is a retroactive payment, not a corrective payment. The CAO authorized SSP beginning 4/1/17 and issued an OTI for Benefit Period 4/1/17-7/31/21.
Example: Richard's J 00 went into suspension from 5/1/20 and then was closed. Richard appealed the termination of his SSI with SSA but did not appeal the termination of SSP. Richard did not receive SSP payments while closed. The appeal with SSA had a positive determination. DHS received an Exchange 6 hit 7/1/21 with Richard in C 01 pay status continuously from his begin date. The CAO cleared the alert without taking action. This was an administrative error. The CAO subsequently received another hit on 8/12/20. This is when DHS became aware of the Administrative error. Richard inquired about any SSP missed during SSI appeal 9/10/21. The CAO correctly issued a One-Time Issuance (OTI) using RC 105 since the Administrative error was first known 8/12/20.
Example: Shelly applied for SNAP and MA after moving to Pennsylvania in 5/20. The CAO received an Exchange 6 hit with a C 01 pay status for Shelly on 6/1/21. The begin date for Shelly's SSI was 2/1/18, and Shelly's SSA residency code changed to Pennsylvania 5/20. The CAO correctly authorized J 00 beginning 5/1/20 and issued an OTI for benefit period 5/1/20-6/30/21.
Updated October 14, 2021, replacing September 11, 2012