910.6 Collection of Overpayments

The CAO will not attempt to settle claims or initiate collection. However, the CAO will accept a payment “on account” if an individual or his representative offers payment to the CAO. The CAO will remit the payment to the OIG. Any payment kept in the CAO must be secured. See Chapter 915, Reimbursement, Appendix C, for receipt of payment procedures.

55 Pa. Code § 255.4(e)

 

Exception: The CAO will not accept a payment from a cash or SNAP individual when the OIG is considering prosecution.

The OIG will recover the overpayment from the individual who received it. The individual is usually the budget group payment name, but may be any adult individual of the budget group that received an overpayment, or the sponsor of an alien.

45 CFR § 233.20(a)(13)

Each adult member of a budget group or SNAP household is jointly and severally responsible for repaying an overpayment.

7 CFR § 273.18(a)

 

910.61 Methods of Recovery

The OIG Avoidance and Recovery System (OARS) will review the overpayment information, including the CAO recommendation to determine what action to take to recover the overpayment. In cases that have been prosecuted, the court will order the method of repayment.

55 Pa. Code § 255.4(e)

Individuals who are not actively receiving TANF, GA or SNAP benefits have three payment options. They are:

NOTE: If an individual does not comply with the payment schedule, OIG may renegotiate the payment schedule at the individual’s request or initiate recoupment if the individual has become active. The individual’s current SNAP allotment may be reduced through recoupment, after proper notification, if the individual does not request renegotiation or make overdue payments. On any overpayment where the recoupment amount would be greater than the installment amount, recoupment is initiated.

Individuals who are actively receiving TANF, GA or SNAP benefits have this payment option:

The OIG will initiate and control recoupment, and remove the reduction when the overpayment is recovered in full. See Appendix D, Recoupment.

Citations:

7 CFR § 273.18(g)

 

 

910.62 Prosecution Cases

Under the Human Services Code, a person who obtains, or aids or abets an individual in obtaining benefits by fraudulent means commits a criminal offense. The term “fraudulent means” includes, but is not limited to, willfully making a false statement, misrepresentation, or impersonation.

55 Pa. Code § 255.2

 

When appropriate, the OIG will initiate a criminal prosecution in the appropriate court. The OIG will notify the CAO of the prosecution. The OIG will not give the individual advance written notification of the criminal prosecution.

55 Pa. Code § 255.4(e)(2)(ii)

CAO employees may be called to testify before district justices, judges, juries, and grand juries.

55 Pa. Code § 255.4(e)(2)(i)

If the individual pleads guilty or is found guilty, the court will order restitution and disqualification will be imposed. The individual will make repayment as ordered by the court. The court may order recoupment, lump sum payments, or installment payments for cash, SNAP and MA cases. The court may also impose fines and/or imprisonment, and/or order disqualification of the individual from the SNAP.  If the individual receives a deferred adjudication, disqualification must be court ordered or a Disqualification Consent Agreement must be signed for  SNAP and Cash Assistance disqualifications to be imposed.

 

 

910.63 Non-prosecution Cases

The OIG recovers non-prosecution claims through either collection or recoupment.

55 Pa. Code § 255.4(e)(3)

For SNAP overpayment cases that are not prosecuted, the OIG sends a Notice Of Food Stamp Overpayment to the individual. The methods of collection are:

For cash assistance cases not referred for prosecution, the method of repayment is collection or recoupment. The OIG may recoup the overpayment in a case providing the OIG sends a timely notice about the overpayment. A notice is timely if sent within six months of the date the CAO  first verified the overpayment.  For medical assistance cases not referred for prosecution, the method of repayment is collection.

 

 

910.631 Cash Assistance Individuals

If the individual is receiving Cash Assistance, the OIG will recover overpayments through recoupment. See Appendix C, Recoupment.

Recoupment is the recovery of an overpayment by reducing an individual’s current assistance benefit. Benefits are reduced by 10% of the family size allowance (FSA) if the overpayment is due to individual error and 5% of the FSA if the overpayment is due to agency error.

Reminder: In order to recover through recoupment, the OIG must notify the individual of the cash overpayment claim within six months of the date the CAO first identified the overpayment, or within one year of the date the CAO first identifies the overpayment, as long as the delay in obtaining verification was caused by an outside source. Other recovery actions may be initiated on all cash overpayments submitted after the above time frames.

The CAO may refer individuals to the OIG’s toll free number 1-800-932-0935 for questions on recoupment.

910.632 Individuals No Longer Receiving Cash Assistance

For individuals who no longer receive assistance, or who were previously being recouped,  the OIG will send a collection letter. The letter notifies the individual of the amount of the overpayment claim and requests full repayment. The individual may choose the type of payment option.

The OIG will not initiate prosecution to recover non-fraud overpayments, but the OIG may initiate civil proceedings or other collection activities if the individual:

The OIG will notify the CAO if a civil action is filed.

Citation:

55 Pa. Code § 255.4(e)(3)(ii)

 

910.64 Exchange of Information

Prompt and accurate communication between the OIG and the CAO is necessary to the recovery of the overpayment.

The CAO is the primary source of information for the OIG and will provide current information to the OIG.

See Appendix C, Recoupment, for instructions.

Citation:

55 Pa. Code § 255.4(f)

Reissued August 13, 2013, replacing  March 16, 2012