Overpayment: This is payment of LIHEAP funds or giving of LIHEAP benefits to someone who is not eligible or only partially eligible.
Liability: When a person or agency gets LIHEAP funds or benefits that they are not supposed to get, the person or agency needs to repay DPW.
Exception: If an overpayment is caused by a CAO error, the agency or person does not need to pay back DPW.
Fraud: A person who knowingly misrepresents or does not provide information in order to qualify someone for a LIHEAP benefit is guilty of fraud and subject to a penalty of a fine, imprisonment or both.
DPW is responsible for identifying overpayments and getting back incorrectly paid LIHEAP funds. The CAO must take the following actions:
Decide whether there was an overpayment.
Figure out the cause of the overpayment.
Collect proof of the cause of the overpayment.
Recommend what should be done about the overpayment.
Give the Office of Inspector General (OIG) any information that might affect the action on the overpayment.
DPW will not seek restitution of any overpayment of less than $25 that occurs because of fraud, error or misrepresentation by either the client or the vendor, but a referral shall be made to the Office of Inspector General.
If there is an overpayment because of suspected fraud, a client mistake or client misrepresentation, DPW must refer the overpayment for collection to the OIG by completing an OIG-189 form (see LIHEAP Forms and Publications). Keep one copy in the LIHEAP record and send all other copies to the OIG.
NOTE: If the person or agency that received the funds returns an uncashed check, there is no overpayment and an OIG-189 is not required.
If there is an overpayment that is not caused by a client’s intentional misrepresentation or fraud, the overpayment must be considered an administrative mistake, and no restitution is required. The client must not be held responsible for repayment of administrative errors, and no referral should be made to the OIG.
If there is an overpayment because of vendor error, misrepresentation or fraud, DPW must take steps, if necessary, to get the money back. An OIG-189 should not be filled out for vendor overpayments. Vendors who receive LIHEAP money for which they are ineligible can contact the Vendor Hotline for instructions on how to return the money.
Any benefit that would have been issued to a vendor who is removed from the participating vendors list must be sent to the client's new vendor or directly to the client in accordance with the LIHEAP State Plan.
If a vendor is removed from active participation in LIHEAP, the vendor cannot be reactivated unless authorization is given by the Vendor Compliance Unit in Harrisburg.
The Bureau of Program Support is responsible for letting CAOs know about all removals and reinstatements of vendors.
If an overpayment occurs that was not caused by vendor fraud, error or misrepresentation, the overpayment must be considered an administrative error, and restitution must not be required. The vendor must not be held responsible for repayment of administrative errors, and no referral should be made to the OIG.
The OIG makes all contacts and performs all collection activities. However, the CAO may accept payments from people who receive benefits, except when the OIG is considering prosecution. If payment is accepted, the CAO must give a receipt to the person making the payment and send the payment to the OIG.
Citations:
Reissued September 28, 2011, replacing September 26, 2011