Current through Register Vol. 63, No. 9, September 1, 2024
(1) In all programs except the Health Systems
Division (HSD) medical, Oregon Supplemental Income Program (OSIP), Oregon
Supplemental Income Program Medical (OSIPM), Qualified Medicare Beneficiaries
(QMB), Refugee Assistance Medical (REFM), Summer EBT (SEBT) and Supplemental
Nutrition Assistance Program (SNAP) or a child care program, the following
persons are liable for repayment of an overpayment (see OAR
461-195-0501):
(a) Each individual in the filing group or
required to be in the filing group and the payee when the
overpayment was incurred, except an individual who did not
reside with and did not know they were included in the filing group.
(b) A caretaker relative
(see OAR 461-001-0000) and their
spouse (see OAR
461-001-0000) who were not part
of, but resided with, the filing group when the overpayment
was incurred.
(c) A
parent (see OAR
461-001-0000) or
caretaker relative of a child (see OAR
461-001-0000) in the
benefit group (see OAR
461-110-0750) and the
spouse of the parent or caretaker
relative if the parent, caretaker
relative, or spouse was a member of or resided with
the filing group when the overpayment was incurred.
(d) An individual determined liable for an
overpayment remains liable when the individual becomes a
member of a new filing group.
(e)
An authorized representative (see OAR
461-115-0090) when the
authorized representative knowingly gave incorrect or
incomplete information or intentionally withheld information resulting in the
overpayment.
(2) In the HSD medical and REFM programs, the
following persons are liable for repayment of an overpayment:
(a) Each individual in the filing group, the
HSD medical programs
eligibility determination group (see OAR
410-200-0015), or required to be
in the filing group and the payee when the
overpayment was
incurred, except an individual who ---
(A)
Was a child or dependent child (see OAR
461-001-0000) at the time of the
overpayment; or
(B) Did not reside with and did not know they
were included in the filing group.
(b) A caretaker relative and
their spouse who were not part of, but resided with, the
filing group or HSD medical programs eligibility determination
group when the overpayment was incurred.
(c) A parent or
caretaker relative of a child in the filing
group or HSD medical programs eligibility determination group
and the spouse of the parent or
caretaker relative if the parent,
caretaker relative, or spouse was a member of
or resided with the filing group or HSD medical programs eligibility
determination group when the overpayment was
incurred.
(d) An authorized
representative (see OAR
461-115-0090 and OAR
410-200-0015) when the
authorized representative knowingly gave incorrect or
incomplete information or intentionally withheld information that resulted in
the overpayment.
(3) In a child care program:
(a) An
overpayment caused by
administrative error is collectible as follows:
(A) The provider is liable for a provider
overpayment made on behalf of a recipient
(see OAR 461-195-0301) eligible for child
care payments.
(B) Each adult in
the filing group or required to be in the filing group is liable for an
overpayment if the recipient was not eligible for the
payment.
(b) Each adult
in the filing group or required to be in the filing group is liable for a
client error overpayment (see OAR
461-195-0501), and a provider is
liable for an overpayment caused by the provider. The
recipient and provider are jointly and severally liable for an
overpayment caused by both. In the case of an alleged provider
overpayment, a provider's failure to provide contemporaneous
records of care provided creates a rebuttable presumption that the care was not
provided.
(c) An adult who cosigned
an application with a minor provider applicant is liable for an
overpayment incurred by the minor provider.
(d) An authorized
representative (see OAR
461-115-0090 and
414-175-0002) is liable for an
overpayment when the authorized
representative knowingly gave incorrect or incomplete information or
intentionally withheld information that resulted in the
overpayment.
(4) In the General Assistance (GA), OSIP,
OSIPM, and QMB programs, the following persons are liable for repayment of an
overpayment:
(a) Each
individual in the filing group or required to be in the filing group and the
payee when the
overpayment was incurred, except an individual
who ---
(A) Was a child or dependent
child at the time of the overpayment; or
(B) Did not reside with and did not know they
were included in the filing group.
(b) A caretaker relative and
their spouse who were not part of, but resided with, the
filing group when the overpayment was incurred.
(c) A parent or
caretaker relative of a child in the filing group and the
spouse of the parent or caretaker
relative if the parent, caretaker
relative, or spouse was a member of or resided with
the filing group when the overpayment was incurred.
(d) An authorized
representative when the authorized representative
knowingly gave incorrect or incomplete information or intentionally withheld
information that resulted in the overpayment.
(5) In the SNAP program, the
following persons are liable for repayment of an overpayment
or a claim that results from trafficking (see OAR
461-195-0601(2))
of SNAP benefits:
(a) The primary
person (see OAR
461-001-0015) of any age, an
ineligible student in the household, and all adults (see OAR
461-001-0015) who were members
of or required to be in the filing group (see OAR
461-110-0370) when excess
benefits were issued.
(b) A sponsor
of a noncitizen household member if the sponsor is at fault, for payments prior
to November 21, 2000.
(c) A drug or
alcohol treatment center or residential care facility that acted as the
authorized representative of the recipient.
(d) An authorized
representative when the authorized representative
knowingly gave incorrect or incomplete information or intentionally withheld
information that resulted in the overpayment.
(e) For a claim that results in trafficking,
the payee and the authorized representative when they actually
traffic the benefits.
(6) Except as provided otherwise in section
(7) of this rule, in all programs, both a noncitizen and the sponsor of the
noncitizen are liable for an overpayment incurred if the
overpayment results from the failure of the sponsor to provide
correct information (see OAR
461-145-0820 to 461-145-0840).
If the sponsor had good cause (see OAR
461-195-0521(5))
for withholding the information, the sponsor is not liable for the
overpayment.
(7)
In the SNAP program, the sponsor of a noncitizen is not liable under section
(6) of this rule for payments on or after November 21, 2000.
(8) In the HSD medical programs, the November
2013 amendments to OAR
461-195-0501,
461-195-0521,
461-195-0541, and
461-195-0561 apply as of October
1, 2013.
(9) In the SEBT program,
the following individuals are liable for repayment of an
overpayment or a claim that results from
trafficking (see OAR
461-195-0601(6)(b))
of SEBT benefits:
(a) All
adults (see OAR 461-196-0020) who were members of or required
to be in the filing group (see OAR 461-196-0020) when excess
benefits were issued.
(b) An
authorized representative (see OAR 461-196-0030) when the
authorized representative knowingly gave incorrect or
incomplete information or intentionally withheld information that resulted in
the overpayment.
Statutory/Other Authority: ORS
409.050,
411.060,
411.404,
411.816,
412.014,
412.049,
329A.500,
413.085 &
414.685
Statutes/Other Implemented: 411.060, 411.404, 411.816,
412.014, 412.049, ORS
409.010,
411.087,
411.630,
411.635,
411.640,
411.690,
416.350 &
329A.500
