Current through Vol. 42, No. 1, September 16, 2024
(a)
Fraud definition. Per
Section
185
of Title 56 of the Oklahoma Statutes(56 O.S. §
185
), fraud in obtaining public assistance occurs when a person:
(1) obtains or attempts to obtain, or aids,
abets, or assists any person to obtain, by means of a false statement or
representation, by false impersonation, by a fictitious transfer, conveyance or
encumbrance of property or income, by a knowing and willful failure to report
to the Oklahoma Department of HumanServices (DHS)income, personal property,
real property, household members, or other material eligibility factors at the
time of application or during the receipt of assistance, or by other fraudulent
device, assistance to which an applicant is not entitled or assistance greater
than that to which an applicant is justly entitled; or
(2) by sale, barter, purchase, theft,
acquisition, possession or use of any electronic benefits or debit card or any
other device authorizing participation in the Temporary Assistance for Needy
Families (TANF) or other DHS program, knowingly obtains, aids, abets, or
assists any person to obtain or attempt to obtain assistance to which a person
is not entitled.
(b)
Fraud penalty. The penalty for fraud is set forth in 56 O.S.
§
185.Per
statutes, only courts can determine guilt and impose a legal penalty for
fraud.
(c)
Office of Inspector
General (OIG) referral by AFS BIR staff. Adult and Family Services (AFS)
Benefit Integrity and Recovery (BIR) staff may refer household error
overpayments of $500 or more to OIG to determine if a referral for judicial
court action is warranted.
(d)
OIG referrals by workers. Workers use Form 19MP001E, Referral
Form, to make an investigative referral to OIG when they suspect fraudulent
intent, but there is insufficient information to calculate an overpayment or
the referral involves a state employee and/or his or her relatives.
(e)
OIG findings. OIG staff
submits findings to AFS BIR for final overpayment calculation and establishment
of the overpayment. When OIG returns the overpayment to AFS BIR and a fraud
determination is not made per (f) or (g) of this Section, the AFS BIR staff
proceeds to collect the debt.
(f)
Fraud determination for State Supplemental Payment (SSP)
overpayments. For SSP, a fraud determination is made when the local,
state, or federal court official agrees to pursue judicial prosecution and the
court finds the debtor(s) guilty of fraud. The debtor(s) is not subject to
disqualification when the court determines fraud occurred; however, he or she
may be subject to some or all of the fraud penalties in (b) of this
Section.
(g)
Intentional
program violation (IPV) determination for TANF overpayments. For TANF,
an IPV determination is made, when:
(1) the
local, state, or federal court official agrees to pursue judicial prosecution
and the court finds the debtor(s) guilty of fraud. When the court decision is a
deferment, the prosecutor asks the accused person to sign Form 19MP002E,
Disqualification Consent Agreement;
(2) Legal Services Appeals Unit staff holds
an administrative disqualification hearing and determines intentional program
violation; or
(3) the debtor(s)
signs Form 08OP016E, Administrative Disqualification Hearing
Waiver.
(h)
TANF
program penalty for overpayments classified as an IPV. Debtor(s) with
TANF overpayments classified as an IPV may be subject to a 25percent payment
standard reduction penalty per Oklahoma Administrative Code
340:10-3-57(g)
in addition to the requirement to repay the overpayment.
(1) AFS BIR staff applies the 25 percent
payment standard reduction penalty period for:
(A) 12 months for the first
violation;
(B) 24 months for the
second violation; and
(C)
permanently for the third violation.
(2) AFS BIR mails the Program
Penalty/Disqualification Notice to the debtor(s). The notice informs the
debtor(s) of the:
(A) IPV
determination;
(B) 25 percent
payment standard reduction penalty; and
(C) date the penalty period starts and
ends.
(3) The 25percent
payment standard reduction penalty begins on the date shown on the notice. Once
the payment standard reduction penalty begins, it runs continuously until the
end of the period imposed regardless of whether the debtor(s) receives TANF
benefits during the penalty period.
(i)
When a court finds the debtor(s)
guilty of fraud. When the court finds the debtor(s) guilty of SSP or
TANF fraud, the court may order a fine, restitution, imprisonment, or any
combination of the three per (b) of this Section. DHS abides by the court
decision.
(1) Court-ordered restitution does
not relieve the debtor(s) of any overpayment amount in excess of the
judgment.
(2) When the court
stipulates a repayment plan, DHS does not renegotiate the repayment plan with
the debtor(s) unless the debtor(s) sentence expired and the court has no action
pending against the debtor(s). (3) When the debtor(s) defaults on court-ordered
restitution, the court may accelerate the sentence, which may include the
debtor(s) serving a prison term. Serving a prison term does not satisfy the
debtor(s)' responsibility to repay the monetary portion of the debt. At that
point the debt may be subject to civil prosecution. (4) The fact that a client
is making restitution payments does not relieve the client of the obligation to
sign Form 08OP002E, Affidavit of Acknowledgment of Indebtedness. Home property
and personal property are exempt from this process. A lien may also be filed on
declared real property when Form 08OP002E indicates property is
owned.
Added at 20 Ok Reg 2059,
eff 7-1-03; Amended at 25 Ok Reg 958, eff 6-1-08; Amended at 28 Ok Reg 880, eff
6-1-11
