112-1          DEFINITION OF FRAUD

Fraud is defined as ”an intentional action, inaction, or statement made by an individual for the purposes of obtaining benefits to which he or she is not entitled.”  To act with intent to defraud means to act willfully, and with the specific intent to deceive or cheat.

Public assistance fraud is frequently referred to as an Intentional Program Violation or IPV Intentional Program Violation.  An IPV Intentional Program Violation may occur with or without a benefit overpayment due to fraud.

112-1 A.     SUPPLEMENTAL NUTRITION ASSISTANCE PROGRAM

An intentional program violation in the SNAP Supplemental Nutrition Assistance Program occurs when a client takes an action for the purpose of qualifying for SNAP Supplemental Nutrition Assistance Program, or for increasing or preventing a reduction in the amount of SNAP Supplemental Nutrition Assistance Program, including ending benefits.  This includes:

• Trading or selling SNAP Supplemental Nutrition Assistance Program benefits;
   

• Using or possessing improperly obtained SNAP Supplemental Nutrition Assistance Program benefits;
   

• Concealing information to obtain benefits to which they are not entitled;
   

• Using SNAP Supplemental Nutrition Assistance Program benefits to purchase items that are not eligible, such as cigarettes or alcohol;
   

• Making a false or misleading statement to the agency, either orally or in writing, to obtain benefits to which they are not entitled; and
   

• Failing to report, as required, changes in income, household composition, or other factors of eligibility in order to obtain benefits to which they are not entitled.

112-1 B.     CASH ASSISTANCE PROGRAMS

An intentional program violation in the cash assistance programs occurs when a client takes an action for the purpose of establishing or maintaining a family's eligibility for Alaska Temporary Assistance or Adult Public Assistance benefits, or for increasing or preventing a reduction in the amount of cash benefits, including ending benefits.  This includes:

• Concealing information;
   

• Making a false or misleading statement to the agency, either orally or in writing; and
   

• Failing to report, as required, changes in income, resources, or any other factors of eligibility.

Example:  

An IPV Intentional Program Violation may result from intentionally failing to report when a child leaves the Alaska Temporary Assistance unit.

112-1 C.     MEDICAID PROGRAMS

An intentional program violation in the Medicaid Program occurs when a client takes an action for the purpose of establishing or maintaining an individual or family's eligibility for Medicaid benefits, including ending benefits.  This includes:

• Concealing information;
   

• Making a false or misleading statement to the agency, either orally or in writing;
   

• Failing to report, as required, changes in income, resources, or any other factors of eligibility.

Note:  

The Fraud Control Unit generally does not address alleged Medicaid provider fraud.