Current through Vol. 42, No. 1, September 16, 2024
(a)
Overpayment determination. Adult and Family Services (AFS) local
office staff calculates overpayments and refers it to AFS Benefit Integrity and
Recovery (BIR) for final determination.
(1)
When the household failed to report earned income timely, per Oklahoma
Administrative Code (OAC)
340:50-9-5, the worker does not
subtract an earned income deduction from gross earnings when calculating the
overpayment amount.
(2) AFS local
office staff documents the circumstances causing the overpayment and the
calculations used to determine the over-issuance amount on Form 08OP005E,
Report of Food Benefit (FB) Overissuance and sends Form 08OP005E and supporting
documentation to AFS BIR staff for claim establishment.
(3) If Office of Inspector General (OIG)
staff determines a trafficking-related offense occurred, AFS BIR staff bases
the overpayment amount on the value of the trafficked benefits. Per Section
273.18(c) of Title
7 of the Code of Federal Regulations, the value of the trafficked benefits is
determined by:
(A) the household member or
authorized representative's admission;
(B) adjudication; or
(C) OIG documentation that formed the basis
for the trafficking determination.
(b)
Overpayment claim
establishment. AFS BIR staff is responsible for evaluating overpayment
referrals, establishing overpayment claims, and referring overpayment claims to
OIG when fraudulent intent is suspected. An overpayment claim is considered
established on the date AFS BIR staff sends the overpayment notice to the
household.
(1) When fraudulent intent is not
suspected, AFS BIR staff:
(A) establishes the
overpayment claim and classifies it as an inadvertent household or agency
error, per OAC
340:50-15-4;
(B) notifies the household and worker, per
(d) and (e) of this Section; and
(C) sets up a repayment plan with the
household, per OAC
340:50-15-6.
(2) When fraudulent intent is suspected, AFS
BIR staff sends the overpayment referral to OIG to determine whether fraudulent
intent occurred. The overpayment claim is not established and notices are not
sent until OIG completes its investigation and releases the claim back to AFS
BIR. Refer to OAC
340:50-15-25 for procedures when
overpayments are referred for an intentional program violation
determination.
(c)
Claim establishment time frame. The amount of time included in an
overpayment claim varies.
(1) From when
Oklahoma Human Services (OKDHS) learned of the overpayment AFS BIRS calculates
all overpayment claims back at least 12 months but no more than six
years.
(2) When AFS BIR classifies
an overpayment as an intentional program violation, the overpayment claim
begins with the month the first intentional program violation occurred, subject
to paragraph (1).
(3) OKDHS
complies with court orders that require a household to pay
restitution.
(d)
Household notification. AFS BIR staff sends the household:
(1) the Notification of Food Benefit
Overpayment notice;
(2) page one of
Form 08OP005E showing the overpayment over-issuance amount; and
(3) Form 08OP118E, Food Benefit Repayment
Agreement.
(e)
Local office notification. After claim establishment, AFS BIR
staff sends the local office:
(1) a copy of
the Notification of Food Benefit Overpayment notice sent to the
client;
(2) the completed Form
08OP005E; and
(3) the County
Notification of Overpayment notice.
Amended at 8 Ok Reg
3463, eff 7-31-91 (emergency); Amended at 9 Ok Reg 3945, eff 6-10-92
(preemptive); Amended at 9 Ok Reg 2473, eff 6-25-92; Amended at 10 Ok Reg 1821,
eff 5-13-93; Amended at 12 Ok Reg 1577, eff 1-27-95 (emergency); Amended at 12
Ok Reg 2443, eff 6-26-95; Amended at 14 Ok Reg 220, eff 10-1-96 (preemptive);
Amended at 14 Ok Reg 964, eff 2-1-97 (emergency); Amended at 14 Ok Reg 1351,
eff 5-12-97; Amended at 25 Ok Reg 1329, eff 6-1-08; Amended at 26 Ok Reg 840,
eff 6-1-09; Amended at 27 Ok Reg 1241, eff
6-1-10
