[27 Pa.B. 3294]
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Regulation Being Considered
Proposed Date
Need and Legal Basis for Action
Agency
for Promulgation Contact Medical assistance estate recovery October 1997, as proposed This regulation will codify the department's collection practices to recover correctly paid ma from the estates of certain deceased recipients age 55 or older who receive Medical Assistance for nursing facility care (includes Intermediate Care Facilities/Mental Retardation and Intermediate Care Facilities/Other Related Conditions), home and community based services, and related hospital prescription drug services. Changes effective August 15, 1994 and are the result of OBRA' 93 and Act 1994-49. Tom Vracarich (717) 783-2209 OBRA 90: Supplemental Security Income-related MA income/resource No publication anticipated in next six months This final omitted regulation codifies seven changes resulting from OBRA 90 that effect the SSI program and therefore the SSI-related program in the areas of income and resources. OBRA 90 also provides a mandatory change to the posteligibility requirements for institutionalized MA eligibles who will have their VA pension reduced to $90 but that will not be counted in determining cost of care. Thus, SSI and SSI-related MA recipients will be positively impacted. The reduction that veterans will contribute toward cost of care will increase federal/state costs but will not affect service delivery. This regulation will be reviewed by representatives of community legal service agencies, the welfare rights organization, and other similar client advocacy groups. Tom Vracarich (717) 783-2209 Disclosure of social security number July 1997, as proposed This regulation incorporates federal requirements that applicants for and recipients of benefits administered by the Department of Public Welfare are required to disclose or apply for a social security number as a condition of eligibility. This regulation will be reviewed by representatives of community legal service agencies, the welfare rights organization, and other similar client advocacy groups. Tom Vracarich (717) 783-2209 Continuation of Medical Assistance throughout pregnancy. December 1997, as final omitted This regulation codifies the provision that Medical Assistance coverage will be continued for pregnant women throughout their pregnancy and postpartum period, regardless of changes in family income that occur after the authorization of MA or cash assistance. This regulation will be reviewed by representatives of community legal service agencies, the welfare rights organization, and other similar client advocacy groups. Tom Vracarich (717) 783-2209 Lump sum payments July 1997, as proposed This proposed regulation will require that any balance remaining of a lump sum that has been treated as income in the calendar month of receipt for the Medical Assistance eligibility determination is treated as a resource in subsequent months. This regulation will be reviewed by representatives of community legal service agencies, the welfare rights organization, and other similar client advocacy groups. Tom Vracarich (717) 783-2209 Veterans Affairs Aid and Attendance July 1997, as final omitted This regulation codifies the provision that the VA aid and attendance benefit received by an MA recipient in a nursing facility is not counted as income when determining the amount of income an individual is expected to pay toward the cost of care. This regulation will be reviewed by representatives of community legal service agencies, the welfare rights organization, and other similar client advocacy groups. Tom Vracarich (717) 783-2209 Emergency Assistance Program July 1997, as proposed This regulation eliminates the allocation of emergency assistance for housing under the cash grant line. Funding for this purpose will be transferred to the Office of Social Programs. This regulation will be reviewed by representatives of community legal service agencies, the welfare rights organization, and other similar client advocacy groups. Tom Vracarich (717) 783-2209 Exclusion of Resources--Medical Assistance children December 1997, as final omitted This regulation codifies the provision that resources are excluded in the Medical Assistance eligibility determination process for supplemental security income (SSI) related, general assistance (GA) related, and TANF-related persons under 21 years of age and for SSI-related, TANF-related, and GA-related families with children under 21 years of age. This regulation will be reviewed by representatives of community legal service agencies, the welfare rights organization, and other similar client advocacy groups. Tom Vracarich (717) 783-2209 Workfare/Community Service January 1998, as proposed The revisions clarify who may be assigned and the priority and factors to be considered in making Workfare program assignments, define responsibilities of county assistance offices and project operators regarding participation expenses and program requirements, and provide for grievance rights for Workfare recipients and regular employees. Provisions of Act 1995-20 will also be incorporated into this regulation package. This regulation will be reviewed by representatives of community legal service agencies, the welfare rights organization, and other similar client advocacy groups. Tom Vracarich (717) 783-2209 General Assistance Restructure --Act 1994-49 August 1997, as final omitted This regulation incorporates provisions of Act 1994-49 including acceptance of written verification of medical disability for chronically needy non-financial eligibility determination; 60-day residency requirement; savings designated for educational purposes; and certain medical services which are no longer compensable expenses. This regulation will be reviewed by representatives of community legal service agencies, the welfare rights organization, and other similar client advocacy groups. Tom Vracarich (717) 783-2209 Elimination of transitionally needy component of general assistance program August 1997, as final omitted This regulation codifies the elimination of cash assistance payments to persons in the GA-Transitional Needy (''TN'') category. References to both the TN and chronically needy (CN) components are deleted since there is no longer a need to differentiate between GA program requirements. This regulation will be reviewed by representatives of community legal service agencies, the welfare rights organization, and other similar client advocacy groups. Tom Vracarich (717) 783-2209 Act 1996-35--General eligibility changes August 1997, as final omitted This regulation codifies statutory changes to eligibility conditions for General Assistance benefits, including the following: expanding the eligibility determination period to 30 days; establishing a period of residency; imposing ineligibility periods based on welfare fraud convictions; limiting Medically Needy Only/Medical Assistance (''MNO/MA'') eligibility to certain groups; and revising the methodology used to determine eligibility for retroactive MNO/MA. This regulation will be reviewed by representatives of community legal service agencies, the welfare rights organization, and other similar client advocacy groups. Tom Vracarich (717) 783-2209 Elimination of PACE requirement December 1997, as final omitted This regulation codifies the elimination of the deduction from income for the PACE program and the mandate to enroll in the PACE program as required by Title XIX. This regulation will be reviewed by representatives of community legal service agencies, the welfare rights organization, and other similar client advocacy groups. Tom Vracarich (717) 783-2209 Change in guardian income deduction No publication anticipated in next six months This regulation provides for a limited income deduction for court-ordered guardian and other fiduciary fees in the Medical Assistance posteligibility determination process for institutionalized patients. This regulation will be reviewed by representatives of community legal service agencies, the welfare rights organization, and other similar client advocacy groups. Tom Vracarich (717) 783-2209 Organ transplants No publication anticipated in next six months This regulation codifies an OBRA '93 requirement that organ transplants are not considered an emergency medical service. This regulation will be reviewed by representatives of community legal service agencies, the welfare rights organization, and other similar client advocacy groups. Tom Vracarich (717) 783-2209 Minor parent September 1997, as final omitted This regulation incorporates Act 1995-20 revisions to the Temporary Assistance for Needy Families and General Assistance general eligibility requirements by adding a condition that, to receive cash assistance, certain minor parents who are applicants or recipients and the dependent children in the minor parent's care, must reside in the home of a parent, legal guardian, other adult relative, or in an adult-supervised supportive living arrangement, unless one of several exceptions is met. Act 35 expanded this provision to include the TANF-related category of categorically needy-nonmoney payment medical assistance. This regulation will be reviewed by representatives of community legal service agencies, the welfare rights organization, and other similar client advocacy groups. Tom Vracarich (717) 783-2209 Real property liens December 1997, as proposed This regulation codifies the elimination of the requirement that applicants who own real property, including mobile homes, which are used as their primary residence, will no longer be required to sign a lien encumbering their residence as a condition of eligibility for cash assistance. This regulation will be reviewed by representatives of community legal service agencies, the welfare rights organization, and other similar client advocacy groups. Tom Vracarich (717) 783-2209 Criminal history September 1997, as final omitted This regulation incorporates the Act 1995-20 provision that prohibits the granting of assistance to any person sentenced for a felony or misdemeanor who has not satisfied the penalty imposed by law by having completed the period of incarceration and by paying all fines, costs, and restitution. Act 1996-35 expands the satisfied penalty requirement to include compliance with an approved payment plan. This regulation will be reviewed by representatives of community legal service agencies, the welfare rights organization, and other similar client advocacy groups. Tom Vracarich (717) 783-2209 Act 1996-35--Provisions Effective March 3, 1997 September 1997, as final omitted This regulation incorporates provisions of the TANF program implemented 3/3/97 by NORC including establishing RESET; requiring applicants and recipients to enter into an agreement of mutual responsibility with the department; establishing a two-tier benefit level based on residency; and further defining Title IV-D cooperation requirements and procedures for TANF and GA applicants and recipients. Act 1996-35 provisions applicable to the TANF program may not be implemented until federal approval is received. This regulation will be reviewed by representatives of community legal service agencies, the welfare rights organization, and other similar client advocacy groups. Tom Vracarich (717) 783-2209 Act 1996-35--Community Service February 1998, as final This proposed regulation would provide that a person who verifies they are actively engaged in volunteer community services for 100 hours per month can qualify for MNO-MA benefits if otherwise eligible. This regulation will be reviewed by representatives of community legal service agencies, the welfare rights organization, and other similar client advocacy groups. Tom Vracarich (717) 783-2209 Veterans Affairs pension to surviving spouse in a nursing facility No publication anticipated in next six months This regulation codifies the exclusion of the aid and attendance benefits of a reduced Veterans Affairs pension to veterans and to the surviving spouses of veterans similarly situated, having no dependents and in a medicaid-funded nursing facility. This regulation will be reviewed by representatives of community legal service agencies, the welfare rights organization, and other similar client advocacy groups. Tom Vracarich (717) 783-2209 Medical support rights September 1997, as final omitted This regulation will require Medical Assistance applicants/ recipients to assign their medical support rights to the Commonwealth and apply for Title IV-D support services as conditions of eligibility. This regulation will be reviewed by representatives of community legal service agencies, the welfare rights organization, and other similar client advocacy groups. Tom Vracarich (717) 783-2209 Annuity rule December 1997, as final omitted This regulation codifies the provision that in addition to the current provision permitting the institutionalized spouse to provide part of his monthly income to the community spouse whose income is below the minimum monthly maintenance needs allowance, either the institutionalized spouse or their representative may file an appeal and seek an administrative order permitting the protection of additional resources to enable the community spouse to purchase an annuity that will generate sufficient income to bring her income up to the minimum monthly maintenance needs allowance. This regulation will be reviewed by representatives of community legal service agencies, the welfare rights organization, and other similar client advocacy groups. Tom Vracarich (717) 783-2209 Intentional Program Violations November 1997, as final omitted This regulation incorporates federal mandates by the U.S. Department of Agriculture and the U.S. Department of Health and Human Services that individuals found to have committed an intentional program violation be subject to an immediate disqualification penalty regardless of the individual's current eligibility status for benefits. This regulation will be reviewed by representatives of community legal service agencies, the welfare rights organization, and other similar client groups. Tom Vracarich (717) 783-2209 Early and Periodic Screening Diagnosis Treatment (EPSDT) October 1997, as final omitted This regulation relating to services provided as a follow-up to an EPSDT visit or encounter that are not currently recognized under the approved Medical Assistance (Medical Assistance) State Plan. This regulation will be reviewed by the medical assistance advisory committee (MAAC) which includes representatives of professional provider associations, providers, the health law project, the welfare rights organization, consumers, and client advocacy groups. Tom Vracarich (717) 783-2209 Clozapine support services August 1997, as final omitted This regulation codifies coverage for psychiatrists, outpatient psychiatric clinics and psychiatric partial hospital facilities for support services provided to MA recipients receiving clozapine. This regulation will be reviewed by the MAAC, as noted above. Tom Vracarich (717) 783-2209 Medical Assistance case management services August 1997, as final omitted This final regulation codifies payment for medically necessary case management services as mandated by Omnibus Budget Reconciliation Act '89 to Medical Assistance recipients under the age of 21. This regulation will be reviewed by the MAAC, as noted above. Tom Vracarich (717) 783-2209 General Assistance restructure --Act 1994-49 August 1997, as final omitted This final regulation codifies Act 1994-49 provisions that affect the medical benefits of General Assistance recipients over the age of 21 when these services are solely state funded. These recipients are no longer eligible for (1) dental services unless their medical condition or handicap requires services to be provided in an ambulatory surgical center, short procedures unit or inpatient hospital; (2) medical supplies and equipment except as prescribed for family planning or with home health agency service; and (3) prescription drugs except legend birth control drugs. This regulation will be reviewed by the MAAC, as noted above. Tom Vracarich (717) 783-2209 Prior authorization August 1997, as final omitted This final regulation adds a prior authorization requirement for home health services, psychiatric partial hospitalization and multisource brand name drugs identified by the department as having equivalent generic drug products available for substitution. This regulation will be reviewed by the MAAC, as noted above. Tom Vracarich (717) 783-2209 Discontinue coverage--infertility August 1997, as final omitted This final regulation codifies Act 1994-49 provisions that discontinues payment for all drugs, devices, products, services and procedures that are used or related to treating infertility, including surrogacy services, effective September 1, 1994. This regulation will be reviewed by the MAAC, as noted above. Tom Vracarich (717) 783-2209 Residential treatment facilities (RTF) for mental health services August 1997, as final omitted This regulation codifies coverage for mental health services to children under 21 years of age that are provided in a residential treatment facility. This regulation will be reviewed by the MAAC, as noted above. Tom Vracarich (717) 783-2209 Pharmaceutical services drug coverage August 1997, as final omitted This regulation provides that the medical assistance program provides drug coverage to medically needy only recipients receiving nursing facility services. This includes medically needy only recipients who reside in nursing facilities and intermediate care facilities/mental retardation (ICF/MR). This regulation will be reviewed by the MAAC, as noted above. Tom Vracarich (717) 783-2209 $150 deductible for General Assistance recipients August 1997, as final omitted This regulation implements Act 1996-35 provisions imposing a $150 deductible on inpatient and outpatient hospital services and ambulatory surgical center services, except laboratory and x-ray services for General Assistance and General Assistance-related Medical Assistance recipients. This regulation will be reviewed by the MAAC, as noted above. Tom Vracarich (717) 783-2209 Inpatient Hospital Services--Negotiated Rate Agreement August 1997, as final omitted This final regulation incorporates the provisions of the negotiated rate agreement between the Department and the hospital industry. This regulation will be reviewed by the MAAC, as noted above. Tom Vracarich (717) 783-2209 REVENUE
Books, Publications and Advertising Materials
61 Pa. Code § 31.29January 1998, as proposed. The Department is amending § 31.29 (relating to books, printed matter and advertising materials) in response to statutory changes and inquiries from the public. Douglas A. Berguson 717-787-1382 Building Maintenance or Building Cleaning Services
61 Pa. Code §§ 55.7 and 60.1January 1998, as proposed. This regulation sets forth the Department s interpretation of 72 P. S. §§ 7201(k)(14), (o)(12) and (aa) and 7204(51) relating to the taxation of building maintenance or building cleaning services. Currently the Department s interpretation is set forth as a pronouncement and codified at § 60.1 (relating to building maintenance or building cleaning services). The Department has concluded that its policy relating to this service should be set forth as a regulation. Therefore, in addition to proposing to add § 55.7 (relating to building maintenance or building cleaning services), the Department is also proposing to delete the pronouncement set forth at § 60.1. Douglas A. Berguson 717-787-1382 Calculation of Title Insurance Company Gross Premiums
61 Pa. Code § 162.11October 1997, as proposed. The Department is proposing a change in the method of calculating the gross premiums tax on title insurance policies for which the issuer charges the insured an all-inclusive fee pursuant to the rate schedule approved by the Pennsylvania Insurance Department. Douglas A. Berguson 717-787-1382 Cigarette Tax
61 Pa. Code, Article IIIJuly 1997, as proposed. This regulation is a comprehensive amendment to the cigarette tax regulations set forth in Title 61, Article III. Cigarette and Beverage Taxes. Douglas A. Berguson 717-787-1382 Compensation; Allowable Deductions From Gross Compensation and Deferred Compensation Arrangements
61 Pa. Code §§ 101.6, 101.6a and 101.6bJanuary 1998, as proposed. The Department is amending §§ 101.6 and adding 101.6a and 101.6b to set forth its interpretation of current case law and current policy in the areas of compensation; commonly recognized old age or retirement benefits; reimbursements of business expenses; and guaranteed payments. Douglas A. Berguson 717-787-1382 Credits Against Tax; Estimated Tax
61 Pa. Code §§ 111.2--111.5, 115.1--115.5, 115.8, 115.9 and 115.11--115.12January 1998, as proposed. This regulation sets forth the Department s policy relating to taxes for which credit is not allowed; other conditions for allowance of the credit for taxes paid to other states; limitations on the amount of the credit for taxes paid to other states; proof requirements; jointly paid estimated tax; and application of overpayments of estimated tax. This regulation is necessary to delete obsolete text; add language consistent with statutory changes; and provide additional guidance in areas that have been subject to questions from the public. Douglas A. Berguson 717-787-1382 Definitions; Net Profits and Regulated Investment Companies
61 Pa. Code §§ 101.1, 103.12 and 155.30January 1998, as proposed. Section 101.1 (relating to definitions) is being amended by replacing the existing definitions of ''employe'' and ''employer'' with new definitions consistent with the requirements of 72 P. S. § 7301(g) and (h). The definition of ''income'' is being expanded to implement the provisions of 72 P. S. § 7602(f)(2)(A) and reflect recent holdings in Morgan v. Commonwealth, 42 Pa. Commonwealth Ct. 557, 400 A.2d 1384 (1979) and Wettach v. Commonwealth, 153 Pa. Commonwealth Ct. 293, 620 A.2d 730 (1993). Section 103.12 (relating to net profits) is also being amended to reflect Morgan and Wettach. The definition of ''personal income tax income'' set forth in § 155.30(b)(4) (relating to regulated investment companies) is being amended to provide that the term means income computed in the same manner and on the same basis as the income of an individual under Article V. Personal Income Tax. Douglas A. Berguson 717-787-1382 Disclaimers of Nonprobate Taxable Assets
61 Pa. Code § 93.81September 1997, as proposed. The regulation sets forth specific conditions that must be met in order for a disclaimer executed in regard to nonprobate taxable assets and nontrust assets of resident decedents to be valid for Pennsylvania inheritance tax purposes. Based on the decision and order received from the Commonwealth Court In Re Estate of Bernecker, 654 A.2d 246 (Pa. Commonwealth 1995), the Department is revising its policy on the effectiveness of disclaimers of nonprobate taxable assets for Pennsylvania inheritance tax purposes. Douglas A. Berguson 717-787-1382 Further Examination of Books and Records
61 Pa. Code §§ 6.22, 8a.1 and 35.1September 1997, as final. This regulation interprets section 2915-A of the act of June 30, 1995 (P. L. 139, No. 21) (Act 21) by adding § 8a.1 (relating to further examination of books and records). It also deletes § 6.22 (relating to further examination of books and records) because the section will not be necessary upon final publication of § 8a.1. To avoid confusion, § 35.1 (relating to tax examinations and assessments) is being amended to delete language that is similar In nature to § 8a.1. Section 2910-A of Act 21 required the Department to develop regulations to implement the provisions of Article XXIX-A. Tax Amnesty Program, of which section 2915-A, further examination of books and records, is a part. Douglas A. Berguson, 717-787-1382
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