SR 05-21 Dated 09/05

STATE OF NEW HAMPSHIRE

INTER-DEPARTMENT COMMUNICATION

 

SIGNATURE DATE:

August 25, 2005

FROM:

OFFICE OF THE DIRECTOR Terry R. Smith

AT (OFFICE):

Division of Family Assistance

TO:

DFA Supervisors

 

SUBJECT:

Recoupment of Erroneously Paid Medical Assistance

EFFECTIVE DATE:

September 1, 2005

 

 

SUMMARY

 

This SR expands policy regarding recoupment of erroneously paid medical assistance.

 

OLD POLICY

EXPANDED POLICY

Erroneously paid medical assistance was subject to recoupment if the erroneous payment was due to the client willfully:

·   withholding information; or

·   failing to comply with eligibility requirements.

Erroneously paid medical assistance is now subject to recoupment if the erroneous payment is due to the client:

·   withholding information or failing to comply with eligibility requirements, regardless of whether the act was willful or not; or

·   making any type of error that results in incorrectly paid benefits.

 

POLICY

 

In addition to recoupment of erroneously paid medical assistance due to withheld information or noncompliance with eligibility requirements, the Department will also now pursue recoupment of incorrectly paid medical benefits due to any type of client error, willful or not.

 

The Department is no longer restricted in recoupment efforts to only those erroneous payments caused by the client willfully withholding information or willfully failing to comply with eligibility requirements. If a client is in error, withholds information, or is noncompliant with eligibility requirements, willful or not, and medical assistance benefits are issued incorrectly, the erroneous payment is subject to recovery by the Department.

 

POLICY MANUAL REVISIONS

 

Revised Family Assistance Manual Topics

 

PART 623   RECOUPMENT OF MEDICAL ASSISTANCE

PART 625   RECOUPMENT: LEGAL ACTION

 

Revised Adult Assistance Manual Topics

 

Section 317.03   Reimbursement-Medical Assistance for Non-Institutionalized Individuals

PART 633   RECOUPMENT OF MEDICAL ASSISTANCE

PART 635   RECOUPMENT: LEGAL ACTION

 

IMPLEMENTATION

 

Policy released by this SR is effective Septembert 1, 2005.

 

CLIENT NOTIFICATION

 

No special client notification is planned or needed.

 

TRAINING

 

No special training is planned or needed.

 

DISPOSITION

 

This SR may be destroyed or deleted after its contents have been noted and the revised manual topics released by this SR have been posted to the On-Line Manuals.

 

DISTRIBUTION

 

This SR will be distributed according to the electronic distribution list for Division of Family Assistance policy releases. This SR, and revised On-Line Manuals, will be available for agency staff in the On-Line Manual Library, and for public access on the Internet at http://www.dhhs.nh.gov/DHHS/DFA/LIBRARY, effective August 29, 2005.

 

This SR, and printed pages with posting instructions, will be distributed under separate cover to all hard copy holders of the Adult Assistance and Family Assistance Manuals.

 

DFA/DMS:s