reglab/statecodes huggingface dataset:
Pennsylvania Code › Title 55 - HUMAN SERVICES › Part II - Public Assistance Manual › Subpart C - Eligibility Requirements › Chapter 140 - SPECIAL MA ELIGIBILITY PROVISIONS › Subchapter C - ELIGIBILITY PROVISIONS FOR EMC UNDER THECATEGORICALLY NEEDY PROGRAM FOR TANF-RELATED CATEGORIES › TYPES OF EARNED INCOME COUNTED › Section 140.451 - Gross earned income

Current through Register Vol. 54, No. 28, July 13, 2024
Gross earned income, including wages, tips, salaries,
						  commissions and bonuses from employment is counted as earned income.
Pennsylvania Code › Title 55 - HUMAN SERVICES › Part II - Public Assistance Manual › Subpart C - Eligibility Requirements › Chapter 140 - SPECIAL MA ELIGIBILITY PROVISIONS › Subchapter C - ELIGIBILITY PROVISIONS FOR EMC UNDER THECATEGORICALLY NEEDY PROGRAM FOR TANF-RELATED CATEGORIES › TYPES OF EARNED INCOME COUNTED › Section 140.452 - Income from self-employment

Current through Register Vol. 54, No. 28, July 13, 2024
Profit from self-employment is determined in accordance
						  with §
												140.52 (relating to profit from
						  self-employment).
Pennsylvania Code › Title 55 - HUMAN SERVICES › Part II - Public Assistance Manual › Subpart C - Eligibility Requirements › Chapter 140 - SPECIAL MA ELIGIBILITY PROVISIONS › Subchapter C - ELIGIBILITY PROVISIONS FOR EMC UNDER THECATEGORICALLY NEEDY PROGRAM FOR TANF-RELATED CATEGORIES › INCOME DEDUCTIONS › Section 140.481 - Deductions from earned income

Current through Register Vol. 54, No. 28, July 13, 2024
(a) An employed recipient whose income is
						used to determine eligibility for EMC is entitled to a deduction from earned
						income for dependent care expenses. Dependent care shall be needed to enable a
						budget group member to retain employment. A dependent care expense is the
						work-related cost of care of dependent children or incapacitated persons living
						in the home of the recipient. The allowable child care costs are actual
						payments made by the recipient, excluding payments received under the
						Transitional Child Care (TCC) provision.
(b) Dependent care services will not be
						considered as needed when an unemployed biological or adoptive parent,
						specified relative or legal guardian of the child is in the home, unless one of
						the following applies:
(1) The biological or
						adoptive parent, specified relative or legal guardian is physically or mentally
						incapable of providing child care.
(2) The biological or adoptive parent,
						specified relative or legal guardian is involved in employment related
						activities, such as education, training and job search.
(3) The child is at risk because of suspected
						child abuse.
Pennsylvania Code › Title 55 - HUMAN SERVICES › Part II - Public Assistance Manual › Subpart C - Eligibility Requirements › Chapter 140 - SPECIAL MA ELIGIBILITY PROVISIONS › Subchapter C - ELIGIBILITY PROVISIONS FOR EMC UNDER THECATEGORICALLY NEEDY PROGRAM FOR TANF-RELATED CATEGORIES › RESOURCE REQUIREMENTS › Section 140.491 - Resources

Current through Register Vol. 54, No. 28, July 13, 2024
Resources are not considered when determining
						  eligibility.
Pennsylvania Code › Title 55 - HUMAN SERVICES › Part II - Public Assistance Manual › Subpart C - Eligibility Requirements › Chapter 140 - SPECIAL MA ELIGIBILITY PROVISIONS › Subchapter C - ELIGIBILITY PROVISIONS FOR EMC UNDER THECATEGORICALLY NEEDY PROGRAM FOR TANF-RELATED CATEGORIES › VERIFICATION REQUIREMENTS › Section 140.501 - Verification of income and child care costs

Current through Register Vol. 54, No. 28, July 13, 2024
Verification of gross monthly earned income, child care
						  costs and household composition shall be submitted in the 4th, 7th and 10th
						  months of the 12-month EMC period.
Pennsylvania Code › Title 55 - HUMAN SERVICES › Part II - Public Assistance Manual › Subpart C - Eligibility Requirements › Chapter 140 - SPECIAL MA ELIGIBILITY PROVISIONS › Subchapter C - ELIGIBILITY PROVISIONS FOR EMC UNDER THECATEGORICALLY NEEDY PROGRAM FOR TANF-RELATED CATEGORIES › BENEFIT COVERAGE › Section 140.511 - Category designation

Current through Register Vol. 54, No. 28, July 13, 2024
A person eligible for EMC is eligible for the full
						  scope of categorically needy medical benefits in the PC or PU categories.
Pennsylvania Code › Title 55 - HUMAN SERVICES › Part II - Public Assistance Manual › Subpart C - Eligibility Requirements › Chapter 140 - SPECIAL MA ELIGIBILITY PROVISIONS › Subchapter C - ELIGIBILITY PROVISIONS FOR EMC UNDER THECATEGORICALLY NEEDY PROGRAM FOR TANF-RELATED CATEGORIES › BENEFIT COVERAGE › Section 140.512 - Eligibility begin date

Current through Register Vol. 54, No. 28, July 13, 2024
The eligibility begin date for EMC is the day following
						  the termination date of TANF Cash Assistance. If the Cash Assistance should
						  have been closed prior to the actual closing date, the EMC begin date is the
						  day following the date AFDC/AFDC-U should have been closed.
Pennsylvania Code › Title 55 - HUMAN SERVICES › Part II - Public Assistance Manual › Subpart C - Eligibility Requirements › Chapter 140 - SPECIAL MA ELIGIBILITY PROVISIONS › Subchapter C - ELIGIBILITY PROVISIONS FOR EMC UNDER THECATEGORICALLY NEEDY PROGRAM FOR TANF-RELATED CATEGORIES › BENEFIT COVERAGE › Section 140.513 - Eligibility end date

Current through Register Vol. 54, No. 28, July 13, 2024
Eligibility for EMC ends under the following
						  conditions:
(1) During the first 6
						months:
(i) When the budget group no longer
						includes a child. Eligibility ends effective the first Medical Assistance
						Identification (MAID) Card issuance deadline date that can be met with the
						appropriate notice.
(ii) When the
						only child in the budget group exceeds the AFDC age requirements in accordance
						with §
													145.43 (relating to requirements).
						Eligibility ends effective the first MAID card issuance deadline date in the
						month following the month the child exceeded the age
						requirement.
Pennsylvania Code › Title 55 - HUMAN SERVICES › Part II - Public Assistance Manual › Subpart C - Eligibility Requirements › Chapter 140 - SPECIAL MA ELIGIBILITY PROVISIONS › Subchapter C - ELIGIBILITY PROVISIONS FOR EMC UNDER THECATEGORICALLY NEEDY PROGRAM FOR TANF-RELATED CATEGORIES › BENEFIT COVERAGE › Section 140.514 - Additions to the budget group

Current through Register Vol. 54, No. 28, July 13, 2024
Additions may be made to the EMC budget group as
						  follows:
(1) A newborn can be added
						any time in the 12-month period.
(2) A person can be added any time in the
						12-month period if the person was in the budget group at the time the
						AFDC/AFDC-U case was closed. Eligibility for other MA Programs is reviewed for
						a person who was not part of the budget group at the time the AFDC/AFDC-U Cash
						Assistance case was closed.
Pennsylvania Code › Title 55 - HUMAN SERVICES › Part II - Public Assistance Manual › Subpart C - Eligibility Requirements › Chapter 140 - SPECIAL MA ELIGIBILITY PROVISIONS › Subchapter C - ELIGIBILITY PROVISIONS FOR EMC UNDER THECATEGORICALLY NEEDY PROGRAM FOR TANF-RELATED CATEGORIES › BENEFIT COVERAGE › Section 140.515 - Deletions to the budget group

Current through Register Vol. 54, No. 28, July 13, 2024
Deletions are made to the EMC budget group as follows:
(1) If a person leaves the household
						in the first 6 months of the EMC 12-month period, the person is removed
						effective the first Medical Assistance Identification (MAID) card issuance
						deadline date that can be met with the appropriate notice. Eligibility for the
						remaining budget group members is determined at the first quarterly review of
						the second 6-month period.
(2) If a
						person leaves the household in the second 6 months of the EMC 12-month period,
						the person is removed effective the first MAID card issuance deadline date that
						can be met with the appropriate notice. Eligibility for the remaining budget
						group members is determined at the next quarterly review.
(3) If a child no longer meets the AFDC age
						requirements and other children are in the budget group, the child is removed
						in the month following the month the child no longer meets the AFDC age
						requirements effective the first MAID card issuance deadline date that can be
						met with the appropriate notice. Prior to terminating EMC, eligibility for
						other MA Programs shall be determined for the child who is deleted.
Pennsylvania Code › Title 55 - HUMAN SERVICES › Part II - Public Assistance Manual › Subpart C - Eligibility Requirements › Chapter 140 - SPECIAL MA ELIGIBILITY PROVISIONS › Subchapter C - ELIGIBILITY PROVISIONS FOR EMC UNDER THECATEGORICALLY NEEDY PROGRAM FOR TANF-RELATED CATEGORIES › REPORTING REQUIREMENTS › Section 140.521 - Reporting requirements

Current through Register Vol. 54, No. 28, July 13, 2024
The recipient shall report gross monthly earned income,
						  allowable child care costs and household composition by the Monthly Reporting
						  Form due date in the 4th, 7th and 10th months of the 12-month EMC period. The
						  Monthly Reporting Form will be used to collect information to determine EMC
						  eligibility. Good cause provisions as defined in Chapter 142 (relating to
						  monthly reporting) apply for failure to report timely. Adverse action will not
						  be taken for failure to report monthly.
This section cited in 55 Pa. Code §
														140.513 (relating to eligibility
							 end date).
Pennsylvania Code › Title 55 - HUMAN SERVICES › Part II - Public Assistance Manual › Subpart C - Eligibility Requirements › Chapter 140 - SPECIAL MA ELIGIBILITY PROVISIONS › Subchapter C - ELIGIBILITY PROVISIONS FOR EMC UNDER THECATEGORICALLY NEEDY PROGRAM FOR TANF-RELATED CATEGORIES › NOTICE, APPEAL AND FAIR HEARING › Section 140.531 - Notice, appeal and fair hearing

Current through Register Vol. 54, No. 28, July 13, 2024
The notice provisions of Chapter 133 (relating to
						  redetermining eligibility) and the appeal and fair hearing provisions of
						  Chapter 275 (relating to appeal and fair hearing and administrative
						  disqualification hearings) apply to recipients of EMC.
Pennsylvania Code › Title 55 - HUMAN SERVICES › Part II - Public Assistance Manual › Subpart C - Eligibility Requirements › Chapter 140 - SPECIAL MA ELIGIBILITY PROVISIONS › Subchapter C - ELIGIBILITY PROVISIONS FOR EMC UNDER THECATEGORICALLY NEEDY PROGRAM FOR TANF-RELATED CATEGORIES › RESTITUTION › Section 140.541 - Restitution

Current through Register Vol. 54, No. 28, July 13, 2024
The restitution requirements in Chapter 255 (relating
						  to restitution) apply to EMC except that there is no overpayment if the
						  recipient reports income, child care costs and household composition accurately
						  and timely and the CAO takes action timely.
Pennsylvania Code › Title 55 - HUMAN SERVICES › Part II - Public Assistance Manual › Subpart C - Eligibility Requirements › Chapter 140 - SPECIAL MA ELIGIBILITY PROVISIONS › Subchapter C - ELIGIBILITY PROVISIONS FOR EMC UNDER THECATEGORICALLY NEEDY PROGRAM FOR TANF-RELATED CATEGORIES › OTHER EXTENDED MEDICAL COVERAGE › Section 140.551 - Extended categorically needy medical benefits due to collection of support

Current through Register Vol. 54, No. 28, July 13, 2024
(a)
						Extended categorically needy medical benefits are provided to AFDC or AFDC-U
						families whose assistance was discontinued as a result, wholly or partly, of
						the collection or increased collection of support and who received AFDC or
						AFDC-U in at least 3 of the 6 months immediately preceding the month in which
						Cash Assistance was discontinued.
(b) Categorically needy medical benefits will
						continue for 4 months beginning with the day following the termination date of
						cash eligibility. When a person's AFDC or AFDC-U payments are discontinued and
						the client has failed to report changes in a timely manner, the 4 months begin
						with the date on which Cash Assistance was erroneously paid.
Pennsylvania Code › Title 55 - HUMAN SERVICES › Part II - Public Assistance Manual › Subpart C - Eligibility Requirements › Chapter 140 - SPECIAL MA ELIGIBILITY PROVISIONS › Subchapter D - ELIGIBILITY PROVISIONS UNDER THE MEDICAID FOR CHILDREN WITH SPECIAL NEEDS CATEGORY › GENERAL ELIGIBILITY PROVISIONS › Section 140.601 - Policy

Current through Register Vol. 54, No. 28, July 13, 2024
(a) A child who
						meets the disability criteria as defined by section 1614 of the Social Security
						Act (42 U.S.C.A. §
													1382c) and who is not receiving benefits
						under Title XVI of the Social Security Act (42 U.S.C.A. §§
													1381-1383f), may qualify for MA
						benefits under this subchapter. MA will be provided in the Medicaid for
						Children with Special Needs Category only if the child does not qualify in any
						other category of MA.
(b) Unless
						there is a provision to the contrary in this subchapter, Subchapter B (relating
						to eligibility provisions for the healthy horizons program for the
						elderly/disabled) applies.
Pennsylvania Code › Title 55 - HUMAN SERVICES › Part II - Public Assistance Manual › Subpart C - Eligibility Requirements › Chapter 140 - SPECIAL MA ELIGIBILITY PROVISIONS › Subchapter D - ELIGIBILITY PROVISIONS UNDER THE MEDICAID FOR CHILDREN WITH SPECIAL NEEDS CATEGORY › GENERAL ELIGIBILITY PROVISIONS › Section 140.602 - Definitions

Current through Register Vol. 54, No. 28, July 13, 2024
The following words and terms, when used in this
						  subchapter, have the following meanings, unless the context clearly indicates
						  otherwise:
Applicant
or
recipient
-A child who meets the eligibility conditions of this
						  subchapter.
Child
-An individual under 18 years of
						  age.
Custodial parent
-The natural or
						  adoptive mother or father living with an applicant or recipient.
Family size
-Includes custodial parent,
						  step-parent, applicant or recipient, siblings of the applicant or recipient and
						  other dependents of the custodial parents listed on the custodial parent's
						  Federal Income Tax Return of the previous calendar year.
Pennsylvania Code › Title 55 - HUMAN SERVICES › Part II - Public Assistance Manual › Subpart C - Eligibility Requirements › Chapter 140 - SPECIAL MA ELIGIBILITY PROVISIONS › Subchapter D - ELIGIBILITY PROVISIONS UNDER THE MEDICAID FOR CHILDREN WITH SPECIAL NEEDS CATEGORY › GENERAL ELIGIBILITY PROVISIONS › Section 140.603 - Conditions of MA eligibility

Current through Register Vol. 54, No. 28, July 13, 2024
(a) An
						applicant or recipient shall meet the eligibility provisions of Subchapter B
						(relating to eligibility provisions for the healthy horizons program for the
						elderly/disabled) except the following types of income are not counted:
(1) Court-ordered child support.
(2) Retirement, Survivor's, Disability
						Insurance (RSDI) benefits received from the Social Security Administration by
						the applicant or recipient.
Pennsylvania Code › Title 55 - HUMAN SERVICES › Part II - Public Assistance Manual › Subpart C - Eligibility Requirements › Chapter 140 - SPECIAL MA ELIGIBILITY PROVISIONS › Subchapter D - ELIGIBILITY PROVISIONS UNDER THE MEDICAID FOR CHILDREN WITH SPECIAL NEEDS CATEGORY › GENERAL ELIGIBILITY PROVISIONS › Section 140.604 - Premiums

Current through Register Vol. 54, No. 28, July 13, 2024
(a)
Eligibility
. An applicant or recipient who meets the
						eligibility conditions specified in §
												140.603 (relating to conditions of
						MA eligibility) shall be eligible for MA upon receipt of payment of a premium,
						if any, established by the Department under subsection (b).
(b)
Calculation of premium
.
(1) The custodial parent shall report and
						verify earned and unearned income and allowable medical and dental
						expenses.
(2) If the custodial
						parent's total gross adjusted earned and unearned income is greater than 200%
						of the Federal Poverty Income Guidelines, the custodial parent's income is
						considered in calculation of the premium.
(3) The medical and dental expenses reported
						on the custodial parent's Federal Income Tax Return of the previous calendar
						year are allowable deductions from the income of the custodial parent as
						specified in paragraph (2).
(i) The
						verification of income is limited to the custodial parent's Federal Income Tax
						Return listing the reported adjusted gross income of the previous calendar
						year.
(ii) If the Federal Income
						Tax Return of the previous calendar year is not available or there is a
						decrease in income from the previous calendar year, any of the following items
						may be used to verify current income:
(A) Pay
						stubs.
(B) Pay envelopes.
(C) Statement by employer.
(D) Other documentary proof of the income of
						the custodial parent.
(iii) The verification of allowable medical
						and dental expenses is limited to those medical and dental expenses that were
						not reimbursed and that the custodial parent deducted on the Federal Income Tax
						Return of the previous calendar year.
(4) The amount of the premium is based on
						income that is considered as specified in paragraph (2) less allowable medical
						and dental expenses specified in paragraph (3) and the family size.
(5) The premium is determined under Appendix
						B (relating to Medicaid for Children with Special Needs Monthly Premium
						Chart).
(6) Revisions to the
						premium amounts will be published as a notice in the
Pennsylvania
						Bulletin
for codification in Appendix B.
(7) The premium is established for a 12-month
						period.
(8) There is one premium
						per family.
(9) The premium can be
						lowered during the 12-month period if the custodial parent reports and verifies
						a decrease in income or an increase in family size.
Pennsylvania Code › Title 55 - HUMAN SERVICES › Part II - Public Assistance Manual › Subpart C - Eligibility Requirements › Chapter 140 - SPECIAL MA ELIGIBILITY PROVISIONS › Subchapter E - THE CATEGORICALLY NEEDY BREAST AND CERVICAL CANCER PREVENTION AND TREATMENT PROGRAM FOR QUALIFIED WOMEN › GENERAL PROVISIONS › Section 140.701 - Policy on Medical Assistance for women with breast or cervical cancer

Current through Register Vol. 54, No. 28, July 13, 2024
The Department provides full MA benefits to uninsured
						  women under 65 years of age who have been screened and diagnosed with breast or
						  cervical cancer, or a precancerous condition of the breast or cervix, who are
						  eligible under the Commonwealth's categorically needy BCCPT
						  Program.
Pennsylvania Code › Title 55 - HUMAN SERVICES › Part II - Public Assistance Manual › Subpart C - Eligibility Requirements › Chapter 140 - SPECIAL MA ELIGIBILITY PROVISIONS › Subchapter E - THE CATEGORICALLY NEEDY BREAST AND CERVICAL CANCER PREVENTION AND TREATMENT PROGRAM FOR QUALIFIED WOMEN › GENERAL PROVISIONS › Section 140.702 - Definitions

Current through Register Vol. 54, No. 28, July 13, 2024
The following words and terms, when used in this
						  chapter, have the following meanings, unless the context clearly indicates
						  otherwise:
BCCPT Program-Breast and Cervical Cancer
						  Prevention and Treatment Program-
A Federally-funded option that
						  provides full MA benefits to uninsured women under 65 years of age who have
						  been screened and diagnosed and are in need of treatment for breast or cervical
						  cancer, or a precancerous condition of the breast or cervix. These women have
						  been identified through an entity funded in full or in part by CDC.
CDC-Centers for Disease Control and
						  Prevention
-The lead Federal agency for protecting the health and
						  safety of people at home and abroad by applying disease prevention and
						  control.
NBCCEDP-National Breast and Cervical Cancer
						  Early Detection Program-
A program established by Congress under the
						  Breast and Cervical Cancer Mortality Act of 1990 (
						  Pub. L. No.
						  101-354, 104 Stat. 409) which authorizes the CDC
						  to promote breast and cervical cancer screening and to pay for screening
						  services for eligible individuals.
Treatment for breast and cervical
						  cancer-
Medical services, which are, or are reasonably expected to
						  provide one of the following:
(i)
						Ameliorate the direct effects of breast or cervical cancer.
(ii) Aid in the clinical characterization of
						breast or cervical cancer, including testing for the effectiveness of curative
						treatment but excluding screening for recurrence or new primary
						cancers.
(iii) Prevent the
						recurrence of breast or cervical cancer.
Uninsured-
Having no "creditable
						  coverage" as the term is defined under the Health Insurance Portability and
						  Accountability Act (HIPAA) (Section 2701(c) of the Public Health Service Act (
						  42 U.S.C.A. §
													300gg(c)(1).
Pennsylvania Code › Title 55 - HUMAN SERVICES › Part II - Public Assistance Manual › Subpart C - Eligibility Requirements › Chapter 140 - SPECIAL MA ELIGIBILITY PROVISIONS › Subchapter E - THE CATEGORICALLY NEEDY BREAST AND CERVICAL CANCER PREVENTION AND TREATMENT PROGRAM FOR QUALIFIED WOMEN › ELIGIBILITY › Section 140.721 - Conditions of eligibility

Current through Register Vol. 54, No. 28, July 13, 2024
Eligibility for MA under the BCCPT Program is based on
						  the requirements in the following chapters:
(1) A woman shall meet the following
						eligibility requirements:
(i) Chapter 125
						(relating to application process).
(ii) Chapter 148 (relating to MA residence
						provisions for categorically needy NMP-MA and MNO-MA).
(iii) Chapter 150 (relating to citizenship
						and alienage provisions for categorically needy NMP-MA and MNO-MA).
(iv) Chapter 155 (relating to
						enumeration).
(v) Chapter 255
						(relating to restitution).
(vi)
						Chapter 257 (relating to reimbursement).
Pennsylvania Code › Title 55 - HUMAN SERVICES › Part II - Public Assistance Manual › Subpart C - Eligibility Requirements › Chapter 140 - SPECIAL MA ELIGIBILITY PROVISIONS › Subchapter E - THE CATEGORICALLY NEEDY BREAST AND CERVICAL CANCER PREVENTION AND TREATMENT PROGRAM FOR QUALIFIED WOMEN › INCOME, RESOURCES AND VERIFICATION › Section 140.731 - Income eligibility limitations

Current through Register Vol. 54, No. 28, July 13, 2024
There are no income limits when determining eligibility
						  under the BCCPT Program. An individual who meets the income limits to be
						  eligible for screening by the CDC's NBCCEDP is income-eligible for the BCCPT
						  Program.
Pennsylvania Code › Title 55 - HUMAN SERVICES › Part II - Public Assistance Manual › Subpart C - Eligibility Requirements › Chapter 140 - SPECIAL MA ELIGIBILITY PROVISIONS › Subchapter E - THE CATEGORICALLY NEEDY BREAST AND CERVICAL CANCER PREVENTION AND TREATMENT PROGRAM FOR QUALIFIED WOMEN › INCOME, RESOURCES AND VERIFICATION › Section 140.732 - Resource eligibility limitations

Current through Register Vol. 54, No. 28, July 13, 2024
There are no resource limits when determining
						  eligibility under the BCCPT Program.
Pennsylvania Code › Title 55 - HUMAN SERVICES › Part II - Public Assistance Manual › Subpart C - Eligibility Requirements › Chapter 140 - SPECIAL MA ELIGIBILITY PROVISIONS › Subchapter E - THE CATEGORICALLY NEEDY BREAST AND CERVICAL CANCER PREVENTION AND TREATMENT PROGRAM FOR QUALIFIED WOMEN › INCOME, RESOURCES AND VERIFICATION › Section 140.733 - Verification requirements

Current through Register Vol. 54, No. 28, July 13, 2024
(a) Under
						the BCCPT Program, the following verification is required:
(1) Verification that the woman was screened
						for breast or cervical cancer, or a precancerous condition of the breast or
						cervix, by a provider or facility funded in full or in part by the CDC under
						its NBCCEDP, and diagnosed and found to need treatment for either breast or
						cervical cancer, or a precancerous condition of the breast or cervix.
						Verification of the continued need for treatment must be provided at each
						partial and complete redetermination.
(2) Verification that the woman is a United
						States citizen or qualified alien as the term is defined in
						8 U.S.C.A. §
														1641(b) (relating to
						definitions).
(3) Verification that
						the woman is under 65 years of age.
(4) Verification that the woman is a resident
						of this Commonwealth.
(5)
						Verification that the woman is uninsured.
Pennsylvania Code › Title 55 - HUMAN SERVICES › Part II - Public Assistance Manual › Subpart C - Eligibility Requirements › Chapter 140 - SPECIAL MA ELIGIBILITY PROVISIONS › Subchapter E - THE CATEGORICALLY NEEDY BREAST AND CERVICAL CANCER PREVENTION AND TREATMENT PROGRAM FOR QUALIFIED WOMEN › REDETERMINATION › Section 140.741 - Complete redetermination

Current through Register Vol. 54, No. 28, July 13, 2024
(a) A
						complete redetermination is required at least every 12 months for women who
						continue to require treatment for either breast or cervical cancer, or a
						precancerous condition of the breast or cervix.
(b) For the BCCPT Program, the eligibility
						factors in §
												133.84(c)
						(relating to MA redetermining eligibility procedures) apply.
Pennsylvania Code › Title 55 - HUMAN SERVICES › Part II - Public Assistance Manual › Subpart C - Eligibility Requirements › Chapter 140 - SPECIAL MA ELIGIBILITY PROVISIONS › Subchapter E - THE CATEGORICALLY NEEDY BREAST AND CERVICAL CANCER PREVENTION AND TREATMENT PROGRAM FOR QUALIFIED WOMEN › REDETERMINATION › Section 140.742 - Partial redetermination

Current through Register Vol. 54, No. 28, July 13, 2024
(a) A
						partial redetermination is required at the end of the initial period of
						treatment for a woman whose initial period of treatment is expected to last
						less than 12 months. The initial period of treatment is based on the diagnosing
						or treating physician's attestation regarding the woman's diagnosis.
(b) For the BCCPT Program, the partial
						redetermination eligibility factors in §
												133.84(d)
						(relating to MA redetermining eligibility procedures) apply.
Pennsylvania Code › Title 55 - HUMAN SERVICES › Part II - Public Assistance Manual › Subpart C - Eligibility Requirements › Chapter 140 - SPECIAL MA ELIGIBILITY PROVISIONS › Subchapter E - THE CATEGORICALLY NEEDY BREAST AND CERVICAL CANCER PREVENTION AND TREATMENT PROGRAM FOR QUALIFIED WOMEN › BENEFIT COVERAGE › Section 140.751 - Benefit coverage

Current through Register Vol. 54, No. 28, July 13, 2024
The Department will provide full MA coverage for a
						  woman determined eligible under the BCCPT Program.
Pennsylvania Code › Title 55 - HUMAN SERVICES › Part II - Public Assistance Manual › Subpart C - Eligibility Requirements › Chapter 140 - SPECIAL MA ELIGIBILITY PROVISIONS › Subchapter E - THE CATEGORICALLY NEEDY BREAST AND CERVICAL CANCER PREVENTION AND TREATMENT PROGRAM FOR QUALIFIED WOMEN › BENEFIT COVERAGE › Section 140.761 - Eligibility begin date

Current through Register Vol. 54, No. 28, July 13, 2024
The eligibility begin date is the date the woman is
						  diagnosed with breast or cervical cancer, or a precancerous condition of the
						  breast or cervix, but not prior to January 1, 2002. Retroactive BCCPT Program
						  benefits are available under §
												140.771 (relating to retroactive
						  eligibility).
Pennsylvania Code › Title 55 - HUMAN SERVICES › Part II - Public Assistance Manual › Subpart C - Eligibility Requirements › Chapter 140 - SPECIAL MA ELIGIBILITY PROVISIONS › Subchapter E - THE CATEGORICALLY NEEDY BREAST AND CERVICAL CANCER PREVENTION AND TREATMENT PROGRAM FOR QUALIFIED WOMEN › BENEFIT COVERAGE › Section 140.771 - Retroactive eligibility

Current through Register Vol. 54, No. 28, July 13, 2024
The earliest possible date for retroactive BCCPT
						  Program benefits to begin is the first day of the third month preceding the
						  month of application, but not prior to January 1, 2002. The period of
						  eligibility for retroactive BCCPT Program benefits begins the first day of the
						  month in which the first medical service was incurred if the applicant was
						  otherwise eligible during that month.
This section cited in 55 Pa. Code §
														140.761 (relating to eligibility
							 begin date).
Pennsylvania Code › Title 55 - HUMAN SERVICES › Part II - Public Assistance Manual › Subpart C - Eligibility Requirements › Chapter 140 - SPECIAL MA ELIGIBILITY PROVISIONS › Subchapter E - THE CATEGORICALLY NEEDY BREAST AND CERVICAL CANCER PREVENTION AND TREATMENT PROGRAM FOR QUALIFIED WOMEN › REPORTING › Section 140.781 - Reporting of changes

Current through Register Vol. 54, No. 28, July 13, 2024
The recipient shall report changes that would affect
						  eligibility for the BCCPT Program under §
												140.721 (relating to conditions of
						  eligibility) to the Department within 10 days from the date of the
						  change.
Pennsylvania Code › Title 55 - HUMAN SERVICES › Part II - Public Assistance Manual › Subpart C - Eligibility Requirements › Chapter 140 - SPECIAL MA ELIGIBILITY PROVISIONS › Subchapter E - THE CATEGORICALLY NEEDY BREAST AND CERVICAL CANCER PREVENTION AND TREATMENT PROGRAM FOR QUALIFIED WOMEN › RIGHT TO APPEAL AND FAIR HEARING › Section 140.791 - Appeal and fair hearing

Current through Register Vol. 54, No. 28, July 13, 2024
The applicant or recipient is entitled to the appeal
						  and fair hearing rights under Chapter 275 (relating to appeal and fair hearing
						  and administrative disqualification hearings).
Pennsylvania Code › Title 55 - HUMAN SERVICES › Part II - Public Assistance Manual › Subpart C - Eligibility Requirements › Chapter 140 - SPECIAL MA ELIGIBILITY PROVISIONS › Subchapter E - THE CATEGORICALLY NEEDY BREAST AND CERVICAL CANCER PREVENTION AND TREATMENT PROGRAM FOR QUALIFIED WOMEN › RIGHT TO APPEAL AND FAIR HEARING › Appendix A - EXTENDED MEDICAL COVERAGE (EMC) MONTHLY INCOME LIMITS 185% OF THE 2013 FEDERAL POVERTY INCOME GUIDELINES

Current through Register Vol. 54, No. 28, July 13, 2024
Family Size
185%
								  of the Federal Poverty Income Guidelines
1
$1,772
2
$2,392
3
$3,011
4
$3,631
5
$4,251
6
$4,871
7
$5,490
8
$6,110
Each Additional Person
$620
This appendix cited in 55 Pa. Code §
														140.431 (relating to income
							 eligibility limits).
Pennsylvania Code › Title 55 - HUMAN SERVICES › Part II - Public Assistance Manual › Subpart C - Eligibility Requirements › Chapter 140 - SPECIAL MA ELIGIBILITY PROVISIONS › Subchapter E - THE CATEGORICALLY NEEDY BREAST AND CERVICAL CANCER PREVENTION AND TREATMENT PROGRAM FOR QUALIFIED WOMEN › RIGHT TO APPEAL AND FAIR HEARING › Appendix B - MEDICAID FOR CHILDREN WITH SPECIAL NEEDS MONTHLY PREMIUM CHART

Current through Register Vol. 54, No. 28, July 13, 2024
Family Size
Parents Annual Income
Parents Annual Income
2
3
4
5
6
7
8
Each Additional
								  member
$0-$39,999.99
NO PREMIUM IF
								  INCOME BELOW 200% FPIG
$40-$49,999.99
$30
$29
$27
$26
$24
$0
$0
$0
$50-$59,999.99
$40
$38
$36
$34
$33
$31
$0
$0
$60-$69,999.99
$50
$48
$45
$43
$41
$39
$37
$0
$70-$79,999.99
$60
$57
$54
$51
$49
$46
$43
$0
$80-$89,999.99
$75
$71
$68
$64
$61
$58
$55
(-$3)
$90-$99,999.99
$100
$95
$90
$86
$81
$77
$73
(-$4)
$100-$109,999.99
$150
$143
$135
$129
$122
$116
$111
(-$5)
$110-$119,999.99
$200
$190
$181
$171
$163
$155
$148
(-$7)
$120-$129,999.99
$250
$238
$226
$214
$204
$193
$185
(-$8)
$130-$139,999.99
$300
$285
$271
$257
$244
$232
$222
(-$10)
$140-$149,999.99
$350
$333
$316
$300
$285
$271
$259
(-$12)
$150-$159,999.99
$400
$380
$361
$343
$326
$310
$297
(-$13)
$160-$169,999.99
$475
$451
$429
$407
$387
$368
$352
(-$16)
$170-$179,999.99
$600
$570
$542
$514
$489
$464
$442
(-$22)
$180-$189,999.99
$675
$641
$609
$579
$550
$522
$497
(-$25)
$190-$199,999.99
$800
$760
$722
$686
$652
$619
$588
(-$31)
$200-$249,999.99
$925
$879
$835
$793
$753
$716
$679
(-$37)
$250-$299,999.99
$1,000
$950
$903
$857
$815
$774
$739
(-$35)
$300-$349,999.99
$1,000
$950
$903
$857
$815
$774
$739
(-$35)
$350-$399,999.99
$1,000
$950
$903
$857
$815
$774
$739
(-$35)
$400-$449.999.00
$1,000
$950
$903
$857
$815
$774
$739
(-$35)
$450-$499,999.99
$1,000
$950
$903
$857
$815
$774
$739
(-$35)
$500,000 +
$1,000
$950
$903
$857
$815
$774
$739
(-$35)
Pennsylvania Code › Title 55 - HUMAN SERVICES › Part II - Public Assistance Manual › Subpart C - Eligibility Requirements › Chapter 141 - GENERAL ELIGIBILITY PROVISIONS › GENERAL PROVISIONS › Section 141.1 - Policy

Current through Register Vol. 54, No. 28, July 13, 2024
(a)
Types
					 of assistance available.
A person in this Commonwealth who is in need
					 may be eligible for one of the following kinds of cash assistance. However, a
					 person may not receive concurrently more than one of the four following
					 categories of cash assistance:
(1) TANF in
					 one of its several forms.
(2)
					 GA.
(3) SBP.
(4) SSI.
Pennsylvania Code › Title 55 - HUMAN SERVICES › Part II - Public Assistance Manual › Subpart C - Eligibility Requirements › Chapter 141 - GENERAL ELIGIBILITY PROVISIONS › ELIGIBILITY PROVISIONS FOR TANF/GA › Section 141.21 - Policy

Current through Register Vol. 54, No. 28, July 13, 2024
(a) In addition to
					 the specific requirements referred to in §§
											141.41 and
					 141.61 (relating to policy; and
					 policy), certain actions will be conditions of eligibility for TANF or GA when
					 an absent parent is involved.
(b)
					 Generally, an assistance unit will be considered for TANF assistance if there
					 is a missing parent which results in deprivation of parental support or care as
					 described in Chapter 153 (relating to deprivation of support or care). However,
					 if the applicant is an unemancipated minor as set forth in §
											145.63 (relating to requirements)
					 who is not eligible for TANF only because of not living with a specified
					 relative, the applicant may qualify for GA. Requirements for obtaining child
					 support will apply in either instance.
(c) As a condition of eligibility for TANF,
					 each applicant/recipient parent, guardian or other caretaker/relative with whom
					 the child is living shall cooperate in the referral process for securing
					 support for children from absent parents prior to the application interview
					 unless good cause is claimed in accordance with subsection (d). Dependent upon
					 household situations, the individual responsible for cooperating is as follows:
(1) When an emancipated minor child,
					 determined to be a specified relative, is living with the emancipated minor
					 child's recipient parent and is included in the grant, the parent shall carry
					 the responsibility for meeting child support requirements.
(2) When an unemancipated minor child,
					 determined to be a specified relative, is the payment name and receiving
					 assistance for herself and children, the unemancipated minor will be considered
					 to be the caretaker/relative and shall carry responsibility for meeting child
					 support requirements.
(3) When
					 court ordered support in the form of alimony is received, due or accrued on
					 behalf of the TANF applicant/recipient parent, guardian or other caretaker or
					 GA applicant/recipient, child support requirements will apply. Reference should
					 be made to §
												187.23 (relating to
					 requirements).
Pennsylvania Code › Title 55 - HUMAN SERVICES › Part II - Public Assistance Manual › Subpart C - Eligibility Requirements › Chapter 141 - GENERAL ELIGIBILITY PROVISIONS › ELIGIBILITY PROVISIONS FOR TANF › Section 141.41 - Policy

Current through Register Vol. 54, No. 28, July 13, 2024
(a)
Conditions of eligibility
. To receive TANF, the applicant or
					 recipient shall meet appropriate eligibility conditions and follow the
					 procedures in this title. The specific eligibility conditions for TANF are in
					 this part or specified in this chapter:
(1)
					 Chapter 145 (relating to age).
(2)
					 Chapter 147 (relating to residence).
(3) Chapter 149 (relating to citizenship and
					 alienage).
(4) Chapter 151
					 (relating to specified relatives).
(5) Chapter 153 (relating to deprivation of
					 support or care).
(6) Chapter 161
					 (relating to persons in institutions).
(7) Chapter 163 (relating to guardians and
					 trustees).
(8) Chapter 165
					 (relating to road to economic self-sufficiency through employment and training
					 (RESET) program).
(9) Chapter 177
					 (relating to resources).
(10)
					 Chapters 125 and 127 (relating to application process; and reserved).
(11) Chapter 255 (relating to
					 restitution).
(12) Chapter 257
					 (relating to reimbursement).
Pennsylvania Code › Title 55 - HUMAN SERVICES › Part II - Public Assistance Manual › Subpart C - Eligibility Requirements › Chapter 141 - GENERAL ELIGIBILITY PROVISIONS › ELIGIBILITY PROVISIONS FOR TANF › Section 141.42 - Definitions

Current through Register Vol. 54, No. 28, July 13, 2024
The following words and terms, when used in this chapter,
						have the following meanings, unless the context clearly indicates
						otherwise:
Adult-supervised supportive living
						arrangement
-A private family setting providing a supportive and
						supervised living arrangement or other living arrangement, including a private
						institution, such as a maternity home or a second-chance home, in accordance
						with §
											161.23 (relating to requirements),
						that:
(i) If subject to approval, is
					 approved in one of two ways:
(A) If a private
					 family setting, the living arrangement has been evaluated and approved by the
					 CAO as conductive to providing a supportive and supervised living arrangement
					 for the minor parent.
(B) If a
					 private institutional setting, the institution is subject to approval by a
					 State agency for health, safety or licensing requirements.
Pennsylvania Code › Title 55 - HUMAN SERVICES › Part II - Public Assistance Manual › Subpart C - Eligibility Requirements › Chapter 141 - GENERAL ELIGIBILITY PROVISIONS › ELIGIBILITY PROVISIONS FOR EXTENDED TANF › Section 141.51 - Policy

Current through Register Vol. 54, No. 28, July 13, 2024
(a) A family that
					 meets the requirements of Chapter 133, §
											141.21 and Chapters 142, 177 and
					 183 may be eligible for Extended TANF under this chapter.
(b) A family otherwise eligible for TANF but
					 for the 60-month time limit on Federally-funded TANF assistance may receive
					 Extended TANF if the eligibility conditions of §
											141.53 (relating to eligibility
					 based on domestic violence) are met or the adult head of household or spouse of
					 head of household who received 60 months of TANF meets the requirements of
					 §
											141.54, §
											141.55 or §
											141.56 (relating to maximizing
					 participation project; mandatory RESET participants; and deferred
					 referral).
(c) A family may receive
					 Extended TANF under more than one section in this chapter. The months during
					 which a family receives Extended TANF need not be sequential.
The provisions of this §
													141.51 issued under sections
						  402(a)(7)(A)(iii) and (B) and 408(a)(7)(A) and (C) of the Social Security Act
						  (42 U.S.C.A. §§
														602(a)(7)(A)(iii) and (B)
						  and 608(a)(7)(A) and
						  (C));
						  45 CFR
						  264.1(c);
						  201(1),
						  401(a),
						  403(b),
						  405,
						  405.1,
						  405.3,
						  432,
						  432(3) and
						  (8) and
						  432.21(a) of the
						  Public Welfare Code (62 P. S. §§
														201(1),
						  401(a), 403(b), 405, 405.1,
						  405.3, 432, 432(3) and (8) and 432.21(a)); the act of May 16, 1996 (P. L. 175,
						  No. 35); and the Domestic Relations Code,
						  23 Pa.C.S. §§
														4301-4381,
						  5103,
						  7101-7901 and
						  8101-8418.
Pennsylvania Code › Title 55 - HUMAN SERVICES › Part II - Public Assistance Manual › Subpart C - Eligibility Requirements › Chapter 141 - GENERAL ELIGIBILITY PROVISIONS › ELIGIBILITY PROVISIONS FOR EXTENDED TANF › Section 141.53 - Eligibility based on domestic violence

Current through Register Vol. 54, No. 28, July 13, 2024
(a)
Eligibility.
A family
					 may receive Extended TANF if the individual or other family member is or has
					 been a victim of domestic violence, as defined in §
											187.22 (relating to definitions)
					 or is at risk of further domestic violence. Eligibility for Extended TANF under
					 this section is subject to the following:
(1)
Verification of domestic violence not required.
No further
					 verification of domestic violence is required if the individual or other family
					 member has met one of the following:
(i) A
					 current or past good cause waiver of child support cooperation
					 requirements.
(ii) A current or
					 past waiver of RESET requirements under Chapter 165 (relating to Road to
					 Economic Self-Sufficiency Through Employment and Training (RESET)).
(iii) Received time-out benefits under
					 Chapter 281 (relating to time-out benefits) based on domestic
					 violence.
Pennsylvania Code › Title 55 - HUMAN SERVICES › Part II - Public Assistance Manual › Subpart C - Eligibility Requirements › Chapter 141 - GENERAL ELIGIBILITY PROVISIONS › ELIGIBILITY PROVISIONS FOR EXTENDED TANF › Section 141.54 - Maximizing participation project

Current through Register Vol. 54, No. 28, July 13, 2024
(a)
Eligibility.
A family
					 may be eligible for Extended TANF under this section if the individual who has
					 received 60 months of TANF assistance meets the requirements of paragraph (1),
					 (2) or (3). The individual is:
(1) Exempt
					 from participation in RESET because the individual is mentally or physically
					 disabled as verified by a physician or licensed psychologist and the disability
					 temporarily or permanently precludes any form of employment or work-related
					 activity.
(2) Not exempt from RESET
					 but has good cause for not complying with RESET and referral to MPP, WPP or
					 another employment and training program was deferred under §
												141.56(a)(2) 
					 (relating to deferred referral).
(3) Exempt from participation in RESET
					 because the individual is the parent or specified relative who is providing
					 care for a child under 6 years of age and for whom alternate child care
					 arrangement is unavailable, and referral to MPP, WPP or another employment and
					 training program was deferred under § 141.56(a)(3).
Pennsylvania Code › Title 55 - HUMAN SERVICES › Part II - Public Assistance Manual › Subpart C - Eligibility Requirements › Chapter 141 - GENERAL ELIGIBILITY PROVISIONS › ELIGIBILITY PROVISIONS FOR EXTENDED TANF › Section 141.56 - Deferred referral

Current through Register Vol. 54, No. 28, July 13, 2024
(a)
General.
A family may qualify for Extended TANF if the
					 individual meets one of the eligibility criteria of paragraphs (1)-(4) and
					 complies with an AMR. The individual is:
(1) A
					 parent in a one-parent household who is caring for a child who has not attained
					 the age of 12 months and the parent is exempt from RESET under §
												165.21(c)(4)
					 (relating to exemptions from RESET participation requirements).
(2) Caring for a disabled child or adult for
					 whom appropriate care is unavailable within a reasonable distance from home or
					 otherwise establishes good cause for not complying with RESET under §
												165.52 (relating to good
					 cause).
(3) The parent or specified
					 relative who is providing care for a child under 6 years of age and for whom
					 alternate child care arrangement is unavailable.
(4) In the process of a compliance review
					 under §
												165.51 (relating to compliance
					 review) or receiving TANF assistance pending timely appeal under §
												275.4(a)(3)(v)(C)(I)
					 (relating to procedures).
Pennsylvania Code › Title 55 - HUMAN SERVICES › Part II - Public Assistance Manual › Subpart C - Eligibility Requirements › Chapter 141 - GENERAL ELIGIBILITY PROVISIONS › ELIGIBILITY PROVISIONS FOR EXTENDED TANF › Section 141.57 - Special allowances

Current through Register Vol. 54, No. 28, July 13, 2024
(a) An
					 individual who receives Extended TANF as specified in §§
											141.53-141.55 (relating to eligibility
					 based on domestic violence; maximizing participation project; and mandatory
					 RESET participants) may receive special allowances under §
											165.41 (relating to eligibility
					 for special allowances for supportive services).
(b) An individual who is eligible for
					 Extended TANF may receive special allowances, including allowances for child
					 care and transportation necessary to enable the individual to participate in
					 programs and activities that are part of the individual's MPP service plan,
					 domestic violence services plan or employment and training activities listed on
					 the AMR.
The provisions of this §
													141.57 issued under sections
						  402(a)(7)(A)(iii) and (B) and 408(a)(7)(A) and (C) of the Social Security Act
						  (42 U.S.C.A. §§
														602(a)(7)(A)(iii) and (B)
						  and 608(a)(7)(A) and
						  (C));
						  45 CFR
						  264.1(c);
						  201(1),
						  401(a),
						  403(b),
						  405,
						  405.1,
						  405.3,
						  432,
						  432(3) and
						  (8) and
						  432.21(a) of the
						  Public Welfare Code (62 P. S. §§
														201(1),
						  401(a), 403(b), 405, 405.1,
						  405.3, 432, 432(3) and (8) and 432.21(a)); the act of May 16, 1996 (P. L. 175,
						  No. 35); and the Domestic Relations Code,
						  23 Pa.C.S. §§
														4301-4381,
						  5103,
						  7101-7901 and
						  8101-8418.
Pennsylvania Code › Title 55 - HUMAN SERVICES › Part II - Public Assistance Manual › Subpart C - Eligibility Requirements › Chapter 141 - GENERAL ELIGIBILITY PROVISIONS › ELIGIBILITY PROVISIONS FOR EXTENDED TANF › Section 141.58 - Appeal rights

Current through Register Vol. 54, No. 28, July 13, 2024
An individual may appeal the denial or termination of
						Extended TANF under Chapter 275 (relating to appeal and fair hearing and
						administrative disqualification hearings).
The provisions of this §
													141.58 issued under sections
						  402(a)(7)(A)(iii) and (B) and 408(a)(7)(A) and (C) of the Social Security Act
						  (42 U.S.C.A. §§
														602(a)(7)(A)(iii) and (B)
						  and 608(a)(7)(A) and
						  (C));
						  45 CFR
						  264.1(c); and
						  201(1),
						  401(a) and
						  403(b) of the
						  Public Welfare Code (62 P. S. §§
														201(1),
						  401(a) and
						  403(b).