111            PROGRAM LOSSES AND CLAIMS COLLECTION

A program loss occurs when a household receives more Alaska Temporary Assistance, Adult Public Assistance, SNAPSupplemental Nutrition Assistance Program, and Senior Benefits that it is entitled to received. The caseworker determines the amount for the program loss. Refer to the Alaska Temporary Assistance, Adult Public Assistance, and SNAPSupplemental Nutrition Assistance Program policy manuals for instructions on how to determine a program loss and appropriate repayment methods.

The following individuals are responsible for paying a claim:

1. Each adult member in the household when the overpayment or trafficking occurred; or

2. A sponsor of an alien household member if the sponsor is at fault; or

3. A person connected to the household such as an authorized representative, including who caused the overpayment or trafficking.

Benefits that are trafficked include:

• Claims arising from trafficking-related offenses will be valued of the trafficked benefits as determined by:

1. The individual's admission

2. Adjudication; or

3. The documentation that forms the basis for the trafficking determination.

After determining the amount of the overpayment, the caseworker will complete a Report of Claim Determination e-Form (GEN 95Report of Claim Determination) for review by a supervisor, case reviewer, or lead worker. The supervisor, case reviewer, or lead worker uploads the GEN 95Report of Claim Determination form and EISEligibility Information System screenshots (TAPDTemporary Assistance Payment Determination screenshots for ATAPAlaska Temporary Assistance Program and FSADFood Stamps Allotment Determination before and after screenshots for SNAPSupplemental Nutrition Assistance Program) into ILINX and submits them to the Benefit Issuance and Recovery Unit in Juneau via email from the Content Store in ILINX. When a caseworker discovers that an APAAdult Public Assistance overpayment has occurred, the GEN 95Report of Claim Determination form and APA 5APA Claims Budget Worksheet budget worksheet must be completed and sent to the supervisor, case reviewer, or lead worker for review. Prior to submission of the GEN 95Report of Claim Determination, a supervisor, case reviewer, or lead worker must review and sign the form to ensure the accuracy of the claim. The BIRUBenefit Issuance & Recovery Unit then establishes the overpayment in EISEligibility Information System and pursues collection of the program loss.

If the caseworker believes that fraud was involved in a program loss, he or she will complete a Fraud Allegation Report form online at https://fcm.i-sight.com/external/dhsscase/new or under Quicklinks at http://dpaweb.hss.state.ak.us/node/15, upload a copy of the fraud report into ILINX using screenshot through Capture and Content Store, and submit the report online to the Fraud Control Unit. Do not complete a Report of Claim Determination (GEN 95) if a fraud report is made. Refer to Chapter 112 for fraud referral procedures.