A child's legal biological or adoptive mother or father whose parental rights have not been terminated. MinnesotaCare also includes a stepparent as a parent.
Parental Fee
An amount assessed to the parents of a minor child as reimbursement for the cost of care of a child under 18 receiving MA without consideration of parental income.
Partnership
A self-employment enterprise in which two or more people share in the profits and losses of the business according to their individual shares of ownership.
Partnership Policy
Long-Term Care insurance that qualifies for asset protection under the Long-Term Care Partnership.
PASS
Plan to Achieve Self Support. A plan approved by the county agency for MA or MSA recipients or approved by the Social Security Administration for SSI recipients which allows certain assets or income of the client to be excluded in determining benefits for some assistance programs.
Paternity
Legal fatherhood, either adjudicated or acknowledged by the father.
Payee
Someone to whom a benefit is paid. Some benefits, such as an annuity contract, may provide for two or more payees. An annuity payee is sometimes called the annuitant; however, a payee may not also be an annuitant.
Payer of Last Resort
The party responsible for payment of medical claims only after all other parties have paid the portion for which they are liable. Clients with Third Party Liability (TPL) must have medical costs paid by the third party before Minnesota Health Care Programs (MHCP) pays claims.
Payment Error Rate Measurement (PERM)
A comprehensive, ongoing audit implemented by the Centers for Medicare and Medicaid Services (CMS) to measure improper payments in the Medicaid program and the State Children's Health Insurance Program (SCHIP). In Minnesota, the DHS Office of Compliance - Internal Audits Office Division conducts MinnesotaCare and Medicaid Eligibility Quality Control (MEQC) eligibility audits and PERM activities.
Payout Phase
See Annuitization Phase.
Payroll Deduction IRA
A retirement savings plan in which an employer sets up a payroll deduction to fund an individual retirement account program with a financial institution, such as a bank, mutual fund or insurance company. The employer establishes either a traditional or Roth IRA (based on the employee’s eligibility and personal choice) with the financial institution. The employer withholds the payroll deduction amounts that the employee has authorized and transmits the funds to the financial institution. The employee and the financial institution are responsible for the amounts contributed.
Pend
The status of an applicant whose eligibility has not yet been approved or denied.
Pending Awaiting Payment
To approve an application conditioned on the receipt of the initial premium payment. For MinnesotaCare, if an application is pending awaiting payment, then the household has been found eligible for MinnesotaCare but will not have coverage until the month after DHS receives the initial payment.
Pension
A fixed sum paid regularly to retired people or their dependents.
Periodic Payment
Payments received at a regular interval, such as monthly, to which the client is entitled under an agreement through a retirement fund, annuity, etc. For annuities, a periodic payment is an annuity payment disbursed to the payee(s) based on a payment interval (i.e., a month, calendar quarter or year) chosen by the annuity owner(s).
PERM
Payment Error Rate Measurement. A comprehensive, ongoing audit implemented by the Centers for Medicare and Medicaid Services (CMS) to measure improper payments in the Medicaid program and the State Children's Health Insurance Program (SCHIP). In Minnesota, the DHS Office of Compliance - Internal Audits Office Division conducts MinnesotaCare and Medicaid Eligibility Quality Control (MEQC) eligibility audits and PERM activities.
Person Master Index (PMI) Number
A unique identification number that MAXIS assigns to each person. The PMI number is used to verify a person's eligibility under the Minnesota Health Care Programs.
Personal Effects
Items of personal property ordinarily worn or carried by the individual, and articles otherwise having an intimate relation to the individual. These include items of cultural or religious significance and items required because of a person’s physical or mental disability. Items that are acquired or held because of their value or as an investment are not considered personal effects.
Personal Needs
See Clothing and Personal Needs Allowance.
Personal Property
Property that is not considered real property.
Personal Responsibility and Work Opportunity Reconciliation Act (PRWORA)
Federal law signed on August 22, 1996 which eliminated the federal entitlement program AFDC and created a new program called Temporary Assistance for Needy Families (TANF). PRWORA provides block grants to states to offer time-limited cash assistance. It also made major changes in the Food Support Program and delinked eligibility for Medicaid from receipt of cash assistance.
PFFS
Private Fee-For-Service Plan. A Medicare Advantage Plan offered by a private insurance company. The plan decides how much it will pay providers and how much enrollees will pay in premiums, deductibles, and other cost sharing. Providers are not required to furnish services to people in PFFS plans. Members must find providers who are willing to accept the plan’s terms of payment. Some PFFS plans include extra benefits at an additional cost to the beneficiary.
Pickle Disregard
An unearned income disregard for some MA clients who lost eligibility for 1619(a), 1619(b), SSI or MSA and would remain eligible if RSDI cost-of-living increases are not counted in the client's net income total.
Plan to Achieve Self Support (PASS)
A plan approved by the county agency for MA or MSA recipients or approved by the Social Security Administration for SSI recipients which allows certain assets or income of the client to be excluded in determining benefits for some assistance programs.
PMAP
Prepaid Medical Assistance Program. The program through which MA managed care enrollees receive medical services.
PMI
Person Master Index Number. A unique identification number that MAXIS assigns to each person. The PMI number is used to verify a person's eligibility under the Minnesota Health Care Programs.
Post-Secondary School
A school serving students beyond the 12th grade, such as a community college, university, or technical college.
Postpartum Period
The period of coverage that begins the last day of the pregnancy and ends the last day of the month in which a 60-day period, beginning on the last day of the pregnancy, ends.
Potluck Processing
The process of applying health care claims to the recipient amount as DHS receives them. DHS does not pay health care claims for any amount equal to or less than the recipient amount shown in MMIS. MMIS issues a monthly Explanation of Medical Benefits (EOMB) that lists the client’s incurred health care expenses for the month. The client uses the EOMB to determine which bills DHS paid and which bills the client is responsible to pay.
Power of Attorney
A legally binding document that authorizes a person or corporation to act on another person’s behalf in financial matters.
Pre-Admission Screening (PAS)
A screening to assess a person’s need for a nursing facility level of care required for all people entering a certified nursing facility, hospital \"swing\" bed, or a certified boarding care facility.
Pre-Existing Condition
A medical condition existing before an insurance policy took effect. Some health insurance policies limit or exclude coverage for pre-existing conditions.
Preferred Remainder Beneficiary
The person or entity required to be named as a beneficiary of a death benefit under an annuity. A preferred remainder beneficiary has preferential rights to the death benefit.
Premium
An amount paid, usually monthly, for a contract of insurance.
Prepaid Medical Assistance Program (PMAP)
The program through which MA managed care enrollees receive medical services.
Presumptive Eligibility
A temporary period of eligibility that is determined at the point of service by certain health care providers using preliminary information. Presumptive eligibility is used in the Minnesota Family Planning Program (MFPP), and MA for Breast and Cervical Cancer (MA-BC).
Preventive Coverage
A term used by insurance companies to describe services provided to keep enrollees healthy and promote continuous health care. Preventive care includes services such as routine physical exams, immunizations, and prenatal care.
Primary Dwelling
The living structure in which an applicant or enrollee, requesting MA payment of LTC services, currently lives in or lived in immediately prior to receiving LTC services. A primary dwelling can be real or personal property, fixed or mobile and can be located on land or water.
PRISM
Minnesota's automated system for the establishment and enforcement of child and medical support.
Private Annuity
An annuity that is purchased and set up by a private individual that is not part of selling the annuity as an employee of an insurance company or financial institution, licensed or regulated by the Minnesota Department of Commerce or a similar agency of another state.
Private Data
Data about individuals which can be disclosed only to the subject of the data or to government entities, employees, and contractors whose work assignments reasonably require access to the data.
Private Fee-For-Service Plan (PFFS)
A Medicare Advantage Plan offered by a private insurance company. The plan decides how much it will pay providers and how much enrollees will pay in premiums, deductibles, and other cost sharing. Providers are not required to furnish services to people in PFFS plans. Members must find providers who are willing to accept the plan’s terms of payment. Some PFFS plans include extra benefits at an additional cost to the beneficiary.
probate
The legal process wherein the estate of a deceased person (decedent) is administered.
Processing Period
The time program rules allow for processing an application.
Profit Sharing Plan
A plan that gives employees a share in the profits of the company. Each employee receives a percentage of those profits based on the company’s earnings. Also known as a deferred profit-sharing plan (DPSP).
Promissory Note
A written, unconditional agreement whereby one party promises to pay a specified sum of money at a specified time (or on demand) to another party. It may be given in return of goods, money loaned, or services rendered.
Property Agreement
A pledge or security of particular property for the payment of a debt or the performance of some other obligation within a specified period.
Protected Asset Limit (PAL)
The total dollar amount of assets a person is allowed to protect through the Long-Term Care Partnership. This amount is equal to the dollar amount of insurance benefits that a Partnership policy has paid on behalf of that person.
Protected Health Information
See Health Insurance Portability and Accountability Act (HIPAA).
PRWORA
Personal Responsibility and Work Opportunity Reconciliation Act. Federal law signed on August 22, 1996 which eliminated the federal entitlement program AFDC and created a new program called Temporary Assistance for Needy Families (TANF). PRWORA provides block grants to states to offer time-limited cash assistance. It also made major changes in the Food Support Program and delinked eligibility for Medicaid from receipt of cash assistance.
Public Data
Data which can be disclosed to anyone for any purpose, such as names and salaries of agency employees.