Part 608 - RETRIEVAL AND CREDIT ADJUSTMENTS FOR REIMBURSEMENT CLAIMING

Doc Status: 
Complete
Statutory Authority: 
Social Services Law, Sections 20, 34, 62, 65, 104, 153

Section 608.1 - Reduction adjustments.

Section 608.1 Reduction adjustments. Receipts or adjustments which should reduce costs or which represent a retrieval of amounts for which reimbursement was claimed must be reflected in current reimbursement claims unless a social services district is required to report or repay such amounts separately or has already repaid the State those amounts not entitled to be retained by the district.

(a) Retrieval adjustments. Amounts a social services district is entitled to receive from clients or providers in repayment of public assistance and care or in repayment for costs incurred, including expenses in protection or liquidation of an asset, will be reflected as retrievals for which adjustment must be made and will include, but not be limited to:

(1) amounts obtained by any legal process authorized by the Social Services Law or any other law;

(2) income from real or personal property assigned to a social services district or otherwise acquired by the district in relation to assistance, care, services or expenditures for a recipient;

(3) repayment by, or voidance of reciprocal amounts otherwise due to, a recipient, a provider, a vendor or other payee or entity entitled to payment; or

(4) other proceeds payable to a social services district for costs subject to reimbursement by the department.

(b) Other credit adjustments. Other amounts required to be reported as decreases in costs must be reflected as reductions, retrievals or other adjustments, as instructed by the department, including but not limited to:

(1) refunds of any type;

(2) monies or value available for credit to a social services agency, but which the agency elects not to collect, enforce or pursue with the direct or implicit approval of the social services district;

(3) cancelled checks or checks which have not cleared through the bank within 90 days from the date of issuance;

(4) cancellations of indebtedness or obligations of a social services district or related governmental entity;

(5) available credits or obligations accruing to the benefit of social services districts or other governmental entities;

(6) receipt of services or benefits by a social services district or other governmental entities in lieu of repayment; or

(7) other transactions or available benefits that should result in reductions of reimbursement or in repayments of reimbursement.

 

Doc Status: 
Complete

Section 608.2 - Adjustment application.

608.2 Adjustment application. Unless otherwise instructed by the department, social services districts must, upon receipt or acknowledgment of a recovery for which there should be a retrieval or credit adjustment, report the gross amount of the recovery in records that will be reflected in the current claim for reimbursement, or alternatively report or repay amounts due to the State as instructed by the department, except that recoveries for defunct programs or activities, including aid to the aged, blind and disabled (AABD) prior to 1974, must be reported and repaid in accord with department instructions for those recoveries.

(a) Adjustments that may be applied to activities to which original costs relate must be applied to such activities as instructed by the department.

(b) Recoveries received in a manner making it impracticable to apply them against specific amounts of assistance, care or expenses must be reported on schedules or formats designated by the department for such recoveries.

(c) Recoveries relating to defunct programs or activities, including AABD, must be deducted from the appropriate totals of reimbursement claimed or paid for the period in which the recovery was received or be returned to the State as instructed by the department during the subsequent claiming period.

(d) Other retrieval or credit adjustments must be applied as instructed by the department. Unless otherwise instructed by the department, portions of adjustments due the State must be remitted during the claiming period following the claiming period in which the recovery was made or within 60 days after receipt or acknowledgement of the recovery, whichever first occurs.

 

Doc Status: 
Complete

Section 608.3 - Adjustment calculation.

608.3 Adjustment calculation. Except as otherwise instructed by the department, retrieval or credit adjustments may be reduced by:

(a) costs of burial of recipients or repayments to local funds for the cost of burial for which State reimbursement has not been claimed;

(b) expenses incurred in the collection of the recovery or in the acquisition of the retrieval or credit adjustment;

(c) expenses related to the maintenance of property not occupied by recipient and nonreimbursable expenses incurred for the protection of the asset;

(d) payments or credits to governmental entities for their proper shares of assistance recovered, provided that any such reduction is reflected in any distribution of costs or revenue for purposes of determining proper shares;

(e) payments to a recipient or his or her estate of any proper residue of recovery; or

(f) amounts specifically permitted by the department as reductions of retrieval or credit adjustments.

Doc Status: 
Complete

Section 608.4 - Adjustment distribution.

608.4 Adjustment distribution. Except as otherwise instructed by the department, retrieval and credit adjustments will be distributed among governmental entities and reimbursement sources as follows:

(a) Retrieval or credit adjustments reflected on formats prepared by the department must be distributed as instructed by the department.

(b) AABD recovery collections, after deduction of authorized expenses and reserves, will be distributed among governmental entities on the basis of shares effective as of January 1, 1974.

(c) Recovery collections for the aid to dependent children (ADC) program, after deduction of authorized expenses and reserves, will be distributed among governmental entities as follows:

(1) Net recovery balances will first be applied in chronological sequence.

(2) Any balance remaining after application of recoveries to assistance previously provided will be apportioned.

(3) Any balance remaining after application of the collection to assistance specified in the other paragraphs of this subdivision may revert to the recipients or their estates.

(d) After deduction of authorized expenses and reserves, net amounts of recovery collections for the following activities will be applied in chronological order against all assistance granted; distribution of the respective determined shares will be made among affected governmental entities:

(1) home relief (including veteran assistance);

(2) adult care, public institution;

(3) child care (foster care) and title IV-E foster care;

(4) adult care, private institutions;

(5) burials; and

(6) medical assistance for needy persons.

(e) Subject to approval by the department, all other retrieval or credit adjustments will be distributed to the programs to which the retrievals or credit adjustments relate.

 

Doc Status: 
Complete

Section 608.5 - Adjustment reports.

608.5 Adjustment reports. Except as otherwise instructed by the department, retrieval or credit adjustments will be reported as follows:

(a) Adjustments required to be reflected on formats prepared by the department will be reported as instructed by the department.

(b) Summaries of retrieval or credit adjustments will be completed and submitted as instructed by the department.

(c) Formats prescribed by the department for recoveries or other retrieval or credit adjustments occurring on a recurring basis, such as rentals or installment payments, will be completed semiannually or otherwise as instructed by the department.

(d) Reports of recoveries or other retrieval or credit adjustments occurring on a nonrecurring basis, such as the sale of real estate or the payment of insurance, and final reports of recurring adjustments will be completed before the end of the subsequent claiming period or within 60 days from receipt of the recovery, retrieval or credit adjustment, whichever first occurs.

 

Doc Status: 
Complete