COURT OF COMMON PLEAS

DOMESTIC RELATIONS SECTION

Mailing Address:

Dauphin County Court House, Box 1295, Harrisburg, PA 17108

SHEILA D. BRITT, ESQ.

Director

JAMES CHAD GUNDERMAN

Assistant Director

(717) 255-2796

(717) 780-6848 Fax

(717) 780-6849 Fax

PACSES CASE ID:

DOCKET NO:

Dear :

In response to your request for enforcement action, you must first have a court order that entitles you to seek reimbursement for unreimbursed medical and/or extracurricular expenses. If court ordered, you may be legally responsible to pay the first $250 annually per person of unreimbursed medical expenses before you can seek payment from the other party. This $250 annual expense shall be prorated for the year in which the support order is effective, thereafter, on an annual bases, January through December. The $250 annual expense does not apply to extracurricular reimbursement. The excess unreimbursed expenses are not assumed entirely by the other party, but these expenses are shared between both parties in proportion to the parties’ net incomes (as stipulated in your Order of Support).

Not all expenses are reimbursable under law. The Pennsylvania Rule of Civil Procedures 1910.16-6(c)(1)-(3), considers medical expenses as annual unreimbursed medical expenses in excess of $250 per person per year. Medical expenses include insurance co-payments and deductibles and all expenses incurred for reasonably necessary medical services and supplies, including but not limited to surgical, dental and optical services, and orthodontia. Medical expenses do not include cosmetic, chiropractic, psychiatric, psychological, or other services unless specifically directed in the order of court. Effective July 1, 2025, this rule amends to include psychiatric and psychological services as medical expenses. Orders entered prior to July 1, 2025 must specifically state psychiatric and psychological services as covered expenses. Thus, before seeking reimbursement, you should carefully review the specific language in your court order concerning unreimbursed expenses to recognize the expenses that qualify for reimbursement under the law.

Additionally, Pa. R.C.P. 1910.16-6(c)(1)-(3) requires that the party seeking payment for unreimbursed expenses provide documentation to the other no later than March 31st of the year following the calendar year in which the party seeking payment received the final bill. Unreimbursed bills do not need to be submitted to the DRS prior to March 31st.

Enforcement of unreimbursed expenses not timely provided by the party seeking payment shall be within the discretion of the court.

In order to process your request, you must comply with service requirements as referenced above and instructions on the enclosed “Medical and Extracurricular Reimbursement Request Requirements.” You can contact our office with any questions at (717) 255-2796.

Sincerely,

Enforcement Clerk 2

Cc: file EN024C

Medical and Extracurricular Reimbursement Request Requirements

In order for our office to accept a reimbursement request, it must follow specific guidelines. Use the list below to make sure your request meets these requirements:

Follow your insurance company’s rules and submit all medical expenses to insurance. If your bill or claim is denied by your insurance, you must include the explanation of benefits provided by your insurance company in your reimbursement request.

The law requires that you have served, or attempted to serve, the other party no later than March 31st of the year following the calendar year in which the party seeking payment received the final bill.

Acceptable forms of service are certified mail, regular mail, email, text, or a parenting app. You must include the completed Affidavit of Service in your reimbursement request.

Once the other party is served notice of the expenses, they have 30 days from the date of service to pay their share of the expense. Do not submit your packet to our office until that 30-day period has ended and payment or an agreed payment plan is not made. The other party must pay you directly, not through the Domestic Relations Office or PA SCDU.

Reimbursement requests must be submitted to our office by June 1st of the year after the expenses were paid in order to be considered for reimbursement. We will only accept requests via paper mail, or hand delivery. Please allow our office 30-60 days after submitting your request for us to process your packet. Parties will be notified of the results by mail.

A maximum of two requests may be submitted in one calendar year, except for an extraordinary circumstance.

Requests that do not comply with the requirements of our office will be returned to you, and our office will not retain any copies. You are able to correct your mistakes or missing information and resubmit it, provided you are still within established deadlines as directed by our office.

The Medical Enforcement Form and/or the Extracurricular Enforcement Form must be completed in full, and each expense you are claiming reimbursement for must be listed on the chart. If needed, you can make copies of the chart for additional space. Please use a separate form for each person.

Our office will determine if you are responsible for and have met the $250 (or prorated) annual expense. This amount will be deducted from your submission to determine the total amount owed to you.

You must provide proof of payment for all expenses included in the request, in the form of receipts or invoices. These must include the date of the appointment or registration, the name of the patient or participant, the total amount owed, the total amount you paid, and the date you made the payment. For medical expenses, it must also include the amount covered by insurance.

Any payments made for prescriptions must include the date, name of the medication, and the patient it was prescribed to. Most pharmacies keep a log in their records that includes this information, and will provide it to you upon request.

Medical and extracurricular requests must be for “reasonably necessary services and supplies”. If something is not considered reasonably necessary, you must include a referral, prescription, or note from the medical provider or organization stating the necessity of the request.

Our office can only accept reimbursement requests for expenses that have already been paid. If you have only paid part of a bill, we will not accept the remainder of the owed expense as a part of the reimbursement. This also applies to recurring expenses.

After we have reviewed your request, a notice will be mailed to both parties with the amount owed and the time frame in which payment must be made. You are responsible for notifying our office if you have not been reimbursed once the allowed time has passed. If no payment has been made, an enforcement conference will be scheduled. Both parties are required to participate. If you have a PFA or other domestic abuse protection in place against the other party, please contact our office to make appropriate arrangements.

To Avoid Resubmission:

Be thorough. If you’re not sure what to include, or if you have any questions regarding the reimbursement requirements or process, call our office and request to speak with the Enforcement department so we can assist you.

EN024C

EN024C

Medical Enforcement Form

Case:___________________	Plaintiff:___________________ vs. Defendant: ___________________

Date of Medical Care	Type of Medical Care	Name of Patient	Total Bill	Insurance Payment	Balance after Insurance	Date other Party Notified

I, ____________________________, verify that the facts set forth in the foregoing medical enforcement form, including all attachments thereto, are true and correct to the best of my knowledge, information, and belief. I understand that false statements herein are made subject to penalties of 18 Pa. C.S. Section 4904 relating to unsworn falsification to authorities.

Date: _________________

Signature: ___________________________________

EN024C

Extracurricular Enforcement Form

Case:___________________	Plaintiff:___________________ vs. Defendant: ___________________

Date of Activity	Type of Activity	Name of Participant	Total Bill	Date other Party Notified

I, ____________________________, verify that the facts set forth in the foregoing extracurricular enforcement form, including all attachments thereto, are true and correct to the best of my knowledge, information, and belief. I understand that false statements herein are made subject to penalties of 18 Pa. C.S. Section 4904 relating to unsworn falsification to authorities.

Date: _________________

Signature: ___________________________________

EN024C