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Elizabeth M. Whitehorn, Director

Provider Notice Issued 03/21/2025

 

To: Long Term Care (LTC) Facilities - Nursing Facilities (NF), Intermediate Care Facilities for Individuals with Intellectual Disabilities (ICF/IID), Supportive Living Program (SLP), Medically Complex for the Developmentally Disabled Facilities (MC/DD) and Specialized Mental Health Rehabilitation Facilities (SMHRF)
​Date March 21, 2025
​Re:
 Social Security Administration Retroactive Payment Information

This notice reminds long term care (LTC) providers how to handle and report lump sum Social Security Administration (SSA) retroactive payments.  

The SSA announced expedited retroactive payments for select individuals. If a resident receives a lump sum payment, the following actions need to be completed:

1.    Report the lump sum to the appropriate Illinois Department of Human Services (DHS) Long Term Care (LTC) Medical Field Operations (MFO) office. This can be reported via provider portal,  Application for Benefits Eligibility (ABE), fax, or mail. Please refer to the Provider Notice issued 12/04/2023 for additional information.

a.    Provide all supporting documentation. This includes bank account statements for the month of the deposit. Customers may have to provide verifications of how the lump sum payment was spent.

2.    Submit an income change in MEDI.

Lump sum payments are considered income the month in which the payment was received and a resource the month after being received. If the lump sum amount remains the following month and it exceeds the $17,500 resource limit, then it will cause a resource reduction. The excess resources will be applied toward the individual’s cost of care. Although resources are not counted for individuals approved under the Affordable Care Act (ACA), resource transfers are still reviewed to determine if allowable. Please refer to the Medicaid policy on Lump Sum Income for additional information.

For more information on the retroactive payments, visit the SSA Benefits website to review the article.

Questions regarding this notice should be directed to the Bureau of Long Term Care at 1-844-528-8444.

 

Kelly Cunningham, Administrator

Division of Medical Programs