The Social Security Cost Reimbursement Program: Submitting a Claim For Cost Reimbursement

Introductions, Federal Ken McGill, Moderator, Ticket to Work Operations Support Manager Nate Arnold, Vocational Rehabilitation/Partnership Plus Lead, SSA Office of Employment Support Programs Kathy Schriver, Senior Analyst, SSA office of Employment Support Programs 12/6/20112Cost Reimbursement Webinar - Part 3: Submitting a Claim

Introductions, State Partners Abygail Medina, Chief, Social Security Programs Section, California Department of Rehabilitation Eugenia Cox, Ticket to Work Program Coordinator, Oregon Office of Vocational Rehabilitation Services Ann Lynn Banton, SSA/Ticket to Work Coordinator, Virginia Department for the Blind and Vision Impaired 12/6/20113Cost Reimbursement Webinar - Part 3: Submitting a Claim

Submitting Cost Reimbursement Claims The State VR Agency must file a claim for payment for each individual case for which it is seeking reimbursement A claim is submitted by completing an SSA-199 or on a paper copy of an electronic facsimile of the SSA- 199 and sending it to SSA SSA is responsible for determining – Whether each claim meets all of the requirements for payment; and – The amount to be paid 12/6/20114Cost Reimbursement Webinar - Part 3: Submitting a Claim

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Completing the SSA-199 State VR Agencies should submit their claims directly to SSA *Claims that are being mailed should be sent to: Social Security Administration Office of Employment Support Programs P.O. Box Baltimore, MD /6/20117Cost Reimbursement Webinar - Part 3: Submitting a Claim

Completing the SSA-199 (continued) Claims that are being sent by UPS or FEDEX should be addressed to: Social Security Administration Office of Employment Support Programs VRA Operations Team 6401 Security Blvd., 2-M-21 Robert Ball Bldg. Baltimore, MD /6/20118Cost Reimbursement Webinar - Part 3: Submitting a Claim

Benefits Status One of the requirements for payment is that the VR consumer be a disability beneficiary (SSDI or SSI) at any time during the period where VR services are provided State VR agencies should verify an individual’s benefit status before filing a reimbursement claim with SSA The electronic process established by OSM/MAXIMUS to place the Tickets of beneficiaries being served under the CR program “In-Use SVR” is one of the ways for a SVRA to verify benefit status 12/6/20119Cost Reimbursement Webinar - Part 3: Submitting a Claim

Earnings As discussed in Part 2 of this webinar series, a State VR Agency has two options for establishing evidence of earnings to qualify for a CR claim: Submit documentation of the beneficiary’s earnings with the claim, or Request that SSA investigate the earnings Remember to consider the appropriate tolerance levels, if appropriate (2011 rates) $ $200 =$1200 (non-blind) $ $100 = $1740 (blind) 12/6/201110Cost Reimbursement Webinar - Part 3: Submitting a Claim

Transitional Work When looking for earnings, we may find earnings below the SGA level for a long period of time and then the earnings eventually leads to SGA. These earnings are called “transitional work” If the Continuous Period of SGA begins more than one year after VR case closure, we will evaluate the claim If we determine that additional information is needed, we will send a letter requesting clarification of how the services provided lead to completion of SGA 12/6/201111Cost Reimbursement Webinar - Part 3: Submitting a Claim

Direct Cost Services Direct costs are costs incurred between the VR case opening and VR closure dates The VR agency should include a month-by-month breakdown of such costs on the SSA-199 (Vocational Rehabilitation Provider Claim) If this documentation is missing, and the payment period does not cover all of the months between VR case opening and closure, SSA will send the VR agency a C7 letter requesting a monthly breakdown of direct costs during the period of VR services. This can occur in the following instances: 12/6/201112Cost Reimbursement Webinar - Part 3: Submitting a Claim

Direct Cost Services (continued) The individual's entitlement or eligibility to benefits started later than the VR case opening; The individual's entitlement or eligibility to benefits ended before the period of VR services ended; or The individual's continuous period of SGA ended earlier than the period of VR services ended Type of service codes are no long required, but service description is still required. 12/6/201113Cost Reimbursement Webinar - Part 3: Submitting a Claim

Cost Formulas Costs for administration, counseling and placement (ACP) incurred in the rehabilitation of beneficiaries are computed based on a cost formula. The cost formula is computed each year by the State VR Agency based on expenditures and case counts in the preceding fiscal year 12/6/201114Cost Reimbursement Webinar - Part 3: Submitting a Claim

Cost Formulas (continued) There are two cost formula options for SVRAs to select from. Both cost formulas use a calculation of: – Administration – Services provided by the State VR Agency – Grants for the establishment/development of community rehabilitation programs – Funds to establish a Business Enterprise Program This data is obtained from the RSA-2 and RSA-113 reports. 12/6/201115Cost Reimbursement Webinar - Part 3: Submitting a Claim

Cost Formulas (continued) Option A – Using the aforementioned calculation and the number of clients served for the fiscal year, we apply a calculation to determine the ACP and the Tracking cost formulas. Option B – Using the aforementioned calculation and the number of newly accepted clients and clients open at the end of the quarterly period for the fiscal year, we apply a calculation to determine the ACP and Tracking cost formulas. 12/6/201116Cost Reimbursement Webinar - Part 3: Submitting a Claim

Pre-Payment Validation Review The Pre-Payment validation review process is used by OESP to ensure that payments made are accurate. This review is done by looking at a small sample of claims OESP will send a letter requesting that the VR agency submit the IPE and all direct cost documents related to the cases being reviewed OESP will validate all direct costs charged If any direct cost item is not validated, that direct cost item will not be paid 12/6/201117Cost Reimbursement Webinar - Part 3: Submitting a Claim

The payment period (for which ACP and Direct Costs can be claimed) starts with the VR start date or when SS benefits began, whichever comes later The payment period ends with the last month of SS benefits or the 9 th month of SGA, whichever comes earlier 12/6/201118Cost Reimbursement Webinar - Part 3: Submitting a Claim SSA Cost Reimbursement Payment Period

Tracking Period The Tracking period (for which tracking costs up to 9 months can be claimed) begins with the month after the VR payment period ended The Tracking period ends with the last month of SGA or the 9 th month after VR case closure, whichever comes earlier 12/6/2011 Cost Reimbursement Webinar - Part 3: Submitting a Claim 19

Period of Services for the State VR Agencies Begins with the first day of the month the beneficiary entered into or started VR services Ends the last day of the month in which the VR agency finished providing services to the individual, i.e., closed the case 12/6/201120Cost Reimbursement Webinar - Part 3: Submitting a Claim

Payment Period/Period of VR The date client entered VR 3/5/08 Date IPE signed3/25/08 Date employment began4/10 Date of final closure7/10 SGA was 5/10 – 3/11 12/6/201121Cost Reimbursement Webinar - Part 3: Submitting a Claim

SSA Cost Reimbursement Payment Period Payment period begins when benefits began (3/1982) or VR start date (03/2008). (Use the later of the two dates) Payment period ends with the last month of benefits (benefits in current pay) or the 9 th month of SGA (3/2011). (Use the earlier of the two dates) The date the payment period begins will be (3/2008) and the date the payment period ends will be (3/2011) 12/6/201122Cost Reimbursement Webinar - Part 3: Submitting a Claim

Period of VR for the State VR Agencies The period of VR is the period during which the beneficiary received VR services and the VR receives direct cost payment It begins with the Date Client Entered VR It ends with the Date of Final VR Closure The period of VR began (3/2008) The period of VR ended (7/2010) 12/6/201123Cost Reimbursement Webinar - Part 3: Submitting a Claim

QUESTIONS? 12/6/201124Cost Reimbursement Webinar - Part 3: Submitting a Claim Click the Attachments button to download associated files

QUESTIONS? 12/6/201125Cost Reimbursement Webinar - Part 3: Submitting a Claim

QUESTIONS? 12/6/201126Cost Reimbursement Webinar - Part 3: Submitting a Claim Click the Attachments button to download associated files

QUESTIONS? 12/6/201127Cost Reimbursement Webinar - Part 3: Submitting a Claim

QUESTIONS? 12/6/201128Cost Reimbursement Webinar - Part 3: Submitting a Claim

QUESTIONS? 12/6/201129Cost Reimbursement Webinar - Part 3: Submitting a Claim