Pennsylvania Code › Title 55 - HUMAN SERVICES › Part II - Public Assistance Manual › Subpart G - Restitution and Reimbursement › Chapter 258 - MEDICAL ASSISTANCE ESTATE RECOVERY › Section 258.2 - 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:
Decedent
-A deceased individual who was 55
					 years of age or older at the time that MA was received.
Decree of distribution
-An instrument by
					 which heirs receive the property of a decedent. It is the final determination
					 of the parties to a proceeding.
Department's claim (claim)
-The claim of
					 the Department computed and made under this chapter.
Fair market value
-The price for which that
					 property would be expected to sell on the open market.
Home and community based services
-A broad
					 array of Medicaid services provided to a decedent to avoid institutionalization
					 under the waiver authority of section 1915(c) of the Social Security Act
					 (42 U.S.C.A. §
											1396n(c)).
Nursing facility services
-General,
					 hospital based, and county nursing facility services and services provided in
					 an intermediate care facility for the mentally retarded or for persons with
					 other related conditions.
Personal representative
-An executor or
					 administrator of a decedent's estate. This includes executors and
					 administrators of any type or description.
Postponement period
-The period during
					 which the Department will defer collection of its claim.
Protectable asset
-An asset which shall be
					 preserved and protected for eventual payment of the Department's claim after
					 the postponement period. The term includes:
(i) Real estate and all improvements
				  thereto.
(ii) An item of personal
				  property with a fair market value in excess of $10,000.
(iii) Cash and cash equivalent assets of an
				  estate with an aggregate value in excess of $50,000. Cash equivalent assets are
				  stocks, bonds, notes, bank accounts, mutual fund shares and other financial
				  instruments convertible into cash.
Real and personal property
-Any property in
					 which a decedent had an ownership interest.
Related hospital and prescription drug
					 services
-Hospital and prescription drug services received by a
					 decedent as follows:
(i) While the
				  decedent was a resident in a nursing facility or was receiving home and
				  community based services.
(ii)
				  While the decedent was on temporary leave from a nursing facility.
(iii) Subsequent to a transfer from a nursing
				  facility to a hospital.
Response period
-The period during which
					 the Department will respond to a notice requesting a statement of claim.
Statement of claim
-A computation of the
					 amount of MA paid for all nursing facility services, home and community based
					 services and related hospital and prescription drug services provided from the
					 time the decedent was 55 years of age and thereafter.
Transferee
-An individual or entity, other
					 than a personal representative, possessing or receiving property subject to the
					 Department's claim. This includes both the initial and any subsequent
					 recipients of property if the property is transferred more than
					 once.