TN 5 (03-03)

GN 00506.130 Fee for Service Notification - Organizations

A. POLICY

Decision notices (authorization or denial) must be given to all FFS applicant organizations. If approved, the notice must include the first month the organization is authorized to collect a fee.

B. PROCEDURE

1. What Month Can the Organization Begin Collecting A Fee?

This date is determined a follows:

A fee can be collected beginning with the first day of the month following:

  • SSA’s approval to collect the fee, AND

  • the organization is the payee of record and received a payment, AND

  • payee services were performed for that month.

2. Collection of fees from conserved funds

Fees should not be collected from conserved funds. The payee must collect the fees anytime during the month they are due (considering all FFS provisions are met.) If the payee decides to collect a lesser fee or to waive the fee altogether for any particular month, it cannot decide later to recoup these fees, either from conserved funds or from future benefits.

It is very important that FO’s make the FFS determination as soon as possible and not exceed the 30 calendar days stipulated in GN 00506.110 B.2.

3. Examples

a. Date the organization can begin collecting the fee

STW Agency files a FFS application on December 6, 2001. The FO manager approves the application and sends all notices on December 21, 2001. STW began serving five or more beneficiaries in October 1999. STW meets all the qualifications and is authorized to collect a fee effective January 1, 2002.

In a similar case, SSA receives the application from STW on December 6, 2001; SSA has 30 days to make a decision. The local FO makes the approval decision on January 2, 2002. The payee can begin collecting the fee on February 1, 2002.

b. Organization re-applies after initial denial

HK Human Services applies to be payee for three beneficiaries on July 1, 2002. HK is a newly created organizational payee, which at the same time applies for FFS status. The FFS application is denied on July 15, 2002, because HK does not yet serve a minimum of five beneficiaries.

On September 18, 2002, HK applies again for FFS status. The organization now provides a list of five beneficiaries. The FO queries the SSN’s and verifies that HK has been payee for these beneficiaries for a minimum of one month and on September 25, 2002, approves HK's application to charge a fee and mails the corresponding notice.

Since HK now meets all the eligibility criteria as a FFS organization, it can collect a fee beginning October 1, 2002.

c. Fees cannot be collected from conserved funds

New Help Services Inc. applies to become a FFS organizational payee on September 18, 2002. The FO makes a delayed decision and approves their request on November 15, 2002. By this time, all the beneficiary’s expenses for November were already paid and any remaining funds deposited into the beneficiary’s conserved funds account.

The payee can begin collecting the fees effective December 1, 2002. The payee cannot collect fees for November, even though the FFS payee may have performed payee duties during that month.

C. TYPE OF NOTICE AND LANGUAGE

Notify organizations of decisions on their requests by using the exhibits in NL 00703.943 and NL 00703.944 (Authorization Notice and Denial Notice).

1. Exhibit

Include the exhibit provided in NL 00703.945 (Explanation of Fees for Representative Payee Services) and if applicable, a list of all the DAA Condition beneficiaries for whom the organization may collect a fee. The FO is responsible for advising the organizational payee of all the beneficiaries that have a DAA condition. Review the MBR/SSR for verification of the DAA Condition indicator. See SM 01601.790 C.19 for the T XVI DAA coding description. For T II, the DAA coding can be found in SM 00510.200 C.22. These DAA Condition beneficiaries may be charged the higher fee amount.

Address the notice to the individual who applied on behalf of the organization. Include the individual's title and the name of the organization in the address information. Include the first month the approved organization is authorized to collect a fee as determined above.

2. Creditor Organization

If the al