Section 600.3 - Reimbursement.

600.3 Reimbursement. (a) Costs subject to reimbursement.

(1) Expenditures for recipients of public assistance, care or services. Assistance properly furnished to eligible recipients of public assistance, care or services may be reimbursed to the extent authorized by law if the social services district which makes the expenditure submits claims to the department in accordance with department regulations and directions.

(2) Administrative expenditures. Expenditures for the administration of public assistance, care and services may be reimbursed if the expenditure is properly made or incurred by a social services district and the district submits a claim for reimbursement in accordance with department regulations and directions.

(3) Other costs. Any costs or adjustments specifically authorized by law will be subject to reimbursement or adjustment as directed by the department, in accordance with applicable provisions of State and Federal law and regulations.

(b) Costs not subject to reimbursement. Except as otherwise provided in this Subchapter, the following provisions concerning the claiming of reimbursement will apply:

(1) Costs subject to reimbursement may not be reported in any manner that results in any portion of such costs being subject to reimbursement more than once.

(2) Any portion of costs that could be reimbursed directly or indirectly by any entity other than the State may not be reported in any manner that results in such costs being reimbursed by the department, unless an appropriate adjustment is made properly reflecting the potential or actual reimbursement by such other entity.

(3) Costs of a social services district that could be reimbursed by an entity whose expenditures are not subject to reimbursement by the department, or whose expenditures have been or will be subject to reimbursement separately by the department, may not be claimed or reported by a social services district in any manner that results in any portion of such costs being subject to reimbursement by the department, unless the claim reflects the potential or actual reimbursement to be made to such other entity.

(4) Costs which are required to be attributed to a particular claiming category or pool must not be reported in a manner that results in any portion of such cost being reimbursed at an unauthorized rate or amount of reimbursement.

(5) Costs for services, supplies, facilities or other items incurred on behalf of a social services district by another agency of a governmental entity must not be reported in a manner that results in any portion of costs that are a general responsibility of such governmental entity being reimbursed by the department, except as permitted within the scope of an authorized cost allocation plan approved for such governmental agency or entity.

(6) Costs that are ascertainable must not be included in any plan, method or function of cost allocation if such inclusion would result in reimbursement greater than that which would be available if the cost had been charged directly to the activity for which reimbursement is claimed, unless such inclusion is directed by the department.

(7) Costs related to the acquisition of land, development of land, the construction of buildings, or the addition to, improvement of, alteration of or replacement of buildings which are of a fixed and durable character, must not be reported in any manner that results in any portion of such cost being subject to reimbursement. However, acquisition, construction, rehabilitation or improvement expenditures, to the extent of the amount appropriated for such purposes and approved by the department for acquiring, constructing, rehabilitating or improving a shelter for adults, and costs for investments in public buildings, claimed only as depreciation as an element of maintenance costs in lieu of rent, may be reported or claimed as directed by the department.

(8) Costs relating to the implementation of cooperative agreements and purchase of service agreements must not be reported in any manner that results in any portion of such cost being subject to reimbursement by the department unless prior approval for such agreement has been obtained from the department or unless such agreement is specifically permitted or required by the Social Services Law, department regulation or policy.

(9) Costs relating to expenditures or adjustments for which prior approval from the department or other entity is required must not be reported in any manner that results in any portion of such cost being subject to reimbursement unless such prior approval has been obtained, as required by the department.

(10) Costs subject to reimbursement must not be reported in any manner which is contrary to department direction.

(c) Limitations and conditions upon reimbursement. (1) Reimbursement will be available only for expenditures permitted by State or Federal law or regulation.

(2) Expenditures subject to reimbursement from more than one claiming classification must be allocated or distributed among the appropriate classifications in accordance with the directions of the department.

(3) All portions of all claims for reimbursement involving Federal participation or reimbursement from entities other than the department must be submitted in accordance with directions of the department, and in the absence of directions of the department, in accordance with directions of the Federal government.

(4) If the requirements for Federal participation or reimbursement from entities, other than the department, are not met by a social services district, the claiming requirements for purposes of State participation in reimbursing the claimed costs have not been fulfilled, unless:

(i) department directions have expressly and specifically set forth requirements that contradict requirements for Federal participation or reimbursement from other entities;

(ii) the department has expressly and specifically determined that State law and department policy require or permit partial or full State reimbursement for the particular items claimed by a district for reimbursement; or

(iii) there is an authorized administrative or legal determination issued or expressly and specifically accepted by the department which lawfully requires or permits partial or full State reimbursement for specific items claimed by districts for reimbursement.

(5) Any rejection, disallowance, recoupment or other reimbursement claim adjustment made by Federal or other authorities, or any penalty imposed or reduction made by such authorities, will result in an adjustment to or reduction of any claim for reimbursement to which such adjustment or reduction applies. In the event the Federal government imposes a fiscal penalty for incorrect issuance of benefits or improper administration of any program subject to Federal financial participation, the department will divide and allocate the penalty between the State and social services districts in a manner calculated to apportion such penalty among subject governmental entities in relation to their responsibility for the assessment of such penalty, and will attribute and assess any such proportion of such penalty to those governmental entities in accordance with such calculation.

(6) Previous claims for reimbursement submitted by any social services district may result in related adjustments to subsequent claims submitted by such district if the department determines that such adjustments are appropriate.

 

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