55 Pa. Code § 258.2

Current through Register Vol. 54, No. 45, November 9, 2024

Section 258.2 - Definitions

The following words and terms, when used in this chapter, have the following meanings, unless the context clearly indicates otherwise:

Decedent-A deceased individual who was 55 years of age or older at the time that MA was received.

Decree of distribution-An instrument by which heirs receive the property of a decedent. It is the final determination of the parties to a proceeding.

Department's claim (claim)-The claim of the Department computed and made under this chapter.

Fair market value-The price for which that property would be expected to sell on the open market.

Home and community based services-A broad array of Medicaid services provided to a decedent to avoid institutionalization under the waiver authority of section 1915(c) of the Social Security Act (42 U.S.C.A. § 1396n(c)).

Nursing facility services-General, hospital based, and county nursing facility services and services provided in an intermediate care facility for the mentally retarded or for persons with other related conditions.

Personal representative-An executor or administrator of a decedent's estate. This includes executors and administrators of any type or description.

Postponement period-The period during which the Department will defer collection of its claim.

Protectable asset-An asset which shall be preserved and protected for eventual payment of the Department's claim after the postponement period. The term includes:

(i) Real estate and all improvements thereto.

(ii) An item of personal property with a fair market value in excess of $10,000.

(iii) Cash and cash equivalent assets of an estate with an aggregate value in excess of $50,000. Cash equivalent assets are stocks, bonds, notes, bank accounts, mutual fund shares and other financial instruments convertible into cash.

Real and personal property-Any property in which a decedent had an ownership interest.

Related hospital and prescription drug services-Hospital and prescription drug services received by a decedent as follows:

(i) While the decedent was a resident in a nursing facility or was receiving home and community based services.

(ii) While the decedent was on temporary leave from a nursing facility.

(iii) Subsequent to a transfer from a nursing facility to a hospital.

Response period-The period during which the Department will respond to a notice requesting a statement of claim.

Statement of claim-A computation of the amount of MA paid for all nursing facility services, home and community based services and related hospital and prescription drug services provided from the time the decedent was 55 years of age and thereafter.

Transferee-An individual or entity, other than a personal representative, possessing or receiving property subject to the Department's claim. This includes both the initial and any subsequent recipients of property if the property is transferred more than once.

55 Pa. Code § 258.2