Section 601.3 - Reimbursement claiming time limits.

601.3 Reimbursement claiming time limits. Except as otherwise provided, to be eligible for State reimbursement, expenditures for public assistance, care and services, or for any other activity which is subject to reimbursement by the department, must be made within the time limits set forth in this section and must be included in a claim submitted by the social services district to the department for the time period in which such expenditures are claimed to have been made.

(a) Claims for expenditures which are subject to reimbursement by the Federal government or entities other than the department must be submitted to the department in sufficient time so that the department can submit claims to the other claiming sources within the time required by such sources. Claims submitted less than 40 days prior to the time by which the department must submit claims for Federal reimbursement may be considered to be submitted without sufficient time for the department to submit such claims to other claiming sources.

(b) All claims for expenditures for which Federal financial participation is available under the Social Security Act must be submitted to the department so that such claim can be included in any claim submissions by the department to the Secretary of the United States Department of Health and Human Services within the two-year period which begins on the first day of the calendar quarter immediately following the calendar quarter in which such expenditures were made, except with respect to any expenditure involving court-ordered retroactive payments or audit exceptions, or adjustments to prior year costs, unless a waiver for good cause has been made by such Secretary for the particular expenditures submitted.

(c) Except as otherwise provided within the requirements for any particular activity, expenditures made by a social services district may not be reimbursed if such costs are related to expenditures, services, supplies or other costs incurred on behalf of a recipient or an individual more than 12 months prior to the month in which the claim for reimbursement is made, unless such costs are specifically approved by the department.

(d) Claims which are rejected will be reexamined only if resubmitted within six months following the date of rejection, provided (1) the initial submittal was made in accordance with the provisions of subdivision (a) of this section, and (2) the costs or expenditures subject to reimbursement in the resubmitted claim are submitted to the department in sufficient time so that the department can submit such claims to any other claiming source within the time required by such source.

(e) The provisions of this section shall not prevent the department from approving and certifying a claim for State reimbursement when in its judgment the claim has merit and, for good cause, could not have been submitted within the time limits prescribed. The provisions of this subdivision may not be interpreted to require the department to approve such claim.

 

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