915.1 General Policy

Reimbursement is the repayment of cash benefits received by an individual, their  spouse, and their unemancipated minor children living with them while awaiting receipt of personal property subject to reimbursement.

55 Pa. Code § 257.22

An individual who is liable for reimbursement must, as a condition of eligibility, sign a reimbursement form agreeing to repay cash benefits received for themself, their spouse, and unemancipated minor children.

55 Pa. Code § 257.24(a)(2)(i)(A)

NOTE:  The individual’s liability for reimbursement differs from their liability to support their spouse and unemancipated minor children.

55 Pa. Code § 257.21(c)(4)

The Department of Human Services (DHS) is responsible for identifying and referring to the Office of State Inspector General (OSIG) personal property subject to reimbursement.

The OSIG’s responsibility is to compute and collect reimbursement claims except for claims involving third party liability (TPL) resources and medical assistance estate recovery.

 

915.11 Benefits Subject to Reimbursement

Reimbursement is required for:

55 Pa. Code § 257.21(b)

 

 

915.12 Benefits Not Subject to Reimbursement

Reimbursement is not required for:

Exception: MA is reimbursable when a third party is liable for payment of the medical services and from the probate estate of specific MA recipients.

55 Pa. Code § 178.6       62 P.S. 1412

55 Pa. Code § 257.23(b)(6)

 

915.13 Liability

The individual is liable for reimbursement beginning with the first assistance check received after:

55 Pa. Code § 257.21(c)(3)

See Appendix A, “Reimbursement Chart” for types of personal property subject to reimbursement.

 

 

 

Updated January 3, 2024, replacing March 14, 2019