Title 16
7000 Cash Assistance Overpayments and Food Stamp Claims
7003 Processing Overpayments and Claims
7003.1 Routing
Information regarding each claim/overpayment is to be transmitted from the DSS local office network to the ARMS Regional Area Office Supervisor as follows:
Suspected Intentional Violations
Suspected intentional violations meeting criteria for DOJ referral specified below are to be transmitted using a "Referral for Prosecution and Overpayment Form." If the criteria is met, ARMS will prepare the overpayment and/or claim for forwarding to DOJ for legal action.
Overpayments/claims should be referred to DOJ for prosecution when the following conditions exist:
• Evidence of intentional violation (e.g., information intentionally omitted from application form), and
• Net overpayment/claim is estimated to exceed $1,000 (overpayment/claim may involve one or more programs, including Medicaid, as long as grand total is at least estimated to be $1,000), or
• Interstate fraud, or
• Case involves a repeat offender with previous documented offenses of $500 or more.
After the overpayment is prepared, it is forwarded to the DOJ. When the overpayment has been processed through the Court system, it is returned by the Attorney General to ARMS. Here the results are logged and the Criminal Justice report is forwarded to DSS. If the client has been found guilty of an intentional Program violation, initiate action to disqualify the individual from the Program and notify ARMS of the disqualification so ARMS can complete the FCS-524 form. ARMS will initiate collection action by mailing a Repayment of Debt agreement and initiating recoupment or allotment reduction when appropriate.
When a DSS case has been referred to the DOJ for prosecution, the casefile is to be intact even though the contents may be more than three years old and otherwise subject to purging, per DSSM 1005.
To alert DSS that a record has been sent to the DOJ and should not be purged, ARMS will forward a copy of the Criminal Justice Report for insertion in the casefile. The presence of these forms will indicate that the case has been referred for prosecution and is to remain intact regardless of case activity status.
Suspected Intentional Violations Under $1,000 and all Non-fraud Violations
Recoupment is automatically initiated when overpayment information is entered into DCIS. The system automatically calculates all case changes that result from rccoupment and sends a notice to the recipient informing them of the changes. The notice is to be mailed at least ten 10) days before the changes will occur. As payments are withheld through recoupment, the system also tracks the overpayment balance. When the balance is zero (0), the system discontinues recoupment. When a regular monthly grant is not issued, the DSS worker is to deduct the monthly recoupment amount and notify ARMS of the amount deducted from the grant. If the recoupment balance is incorrect or a case has not been placed on recoupment, ARMS will enter the correct balance into DCIS. Allotment Reduction for food stamp claims is handled by ARMS (See DSSM 7004 ).
Food Stamp claims are forwarded within ARMS to the Accounting Section for establishment of an Accounts Receivable and collection action. The Accounting Section is responsible for issuing demand letters and negotiation of a Repayment of Debt agreement stipulating the amount of the debt, the methods available for repayment and the terms of the agreement schedule. A copy of the agreement will be forwarded to the client.
Claims involving suspected intentional Food Stamp Program violations (in amounts less than $1,000) are forwarded to the DSS Administrative Hearing Officer by ARMS. Cases which are declined for a hearing due to lack of evidence will be returned to ARMS for forwarding to the DSS worker for recalculation.
Following an Administrative Hearing, the Hearing Officer will notify ARMS of the outcome of the hearing by providing a copy of the hearing decision.
Food Stamp Administrative disqualification hearings are further discussed in DSSM 2023 .
CASH ASSISTANCE OVERPAYMENTS
1. Calculate the overpayment as per DSSM 7002.1 .
2. Complete Part A of form 920. Then send the overpayment package with form 920 to the Operations Administrator via the supervisor for approval and signature.
3. Open Cash Assistance Cases
a) Date the notice and copy it. Mail one overpayment package to the client, send one overpayment package to ARMS with form 920, and file one overpayment package on the record.
b) Prior to taking further action, wait thirteen days from the date the notice is mailed to the client to see if the client requests a fair hearing.
c) If the client doesn't request a fair hearing, initiate recoupment as appropriate using reason code 757 in Section 2.
* Check with ARMS to determine the balance amount if a prior overpayment is being recouped. Once the amount is determined, enter the amount in Section 12.
4. Closed Cash Assistance Cases
Date the notice and copy it. Mail one overpayment package to the client. Send one overpayment package (with Form 920) to ARMS with a note indicating that the case is closed and that the client was noticed. File one overpayment package in the case record.
FOOD STAMP CLAIMS
1. Calculate the amount of the overpayment as per 7002.2 .
2. Complete Form 920, Part A and send it to the Operations Administrator via the supervisor for approval and signature.
3. Date the notice and copy it. Send two (2) overpayment packages to ARMS and file one overpayment package in the case record.
4. ARMS will send out overpayment package to the client with a repayment demand letter.
COMBINED CASH ASSISTANCE OVERPAYMENTS AND FOOD STAMP CLAIMS
1. Handle Cash Assistance overpayments as instructed above.
2. Handle Food Stamp claims as instructed above.
