112-10        BENEFIT ISSUANCE AND RECOVERY UNIT'S ROLE

The Claims Specialist establishes claims and collects all program losses from clients who received more benefits than they were entitled.  This includes maintaining records and collecting IPV Intentional Program Violation overpayments for Temporary Assistance, Supplemental Nutrition Assistance Program (SNAP Supplemental Nutrition Assistance Program), Adult Public Assistance, and Medicaid.  See the Administrative Manual section 111 for more information on processing claims.

112-10 A.   DISQUALIFIED INDIVIDUAL FOR IPV Intentional Program Violation

Once the FCU Fraud Control Unit completes a fraud investigation and has proven a recipient has committed an ATAP Alaska Temporary Assistance Program and/or SNAP Supplemental Nutrition Assistance Program IPV Intentional Program Violation, by way of an Administrative Disqualification Hearing (ADH) decision, a signed Waiver of an ADH, or a Criminal Court Order of Judgment, the FCU Fraud Control Unit ET Eligibility Tehnician III’s will take action to impose appropriate IPV Intentional Program Violation and DQ penalty(s) ensuring all program recipient cases are acted on timely and notice is sent from EIS Eligibility Information System.  FCU Fraud Control Unit staff will also update the Electronic Disqualified Recipient System (eDRS) that a SNAP Supplemental Nutrition Assistance Program IPV Intentional Program Violation has occurred.  Upon receipt of the documents from the FCU Fraud Control Unit, the BIR Unit will continue with the process of establishing all fraud claims for overpayment collection and sending notices to the recipient(s).

112-10 B.   ESTABLISHING AND COLLECTING FRAUD CLAIMS

The Claims Specialist establishes a claim on EIS Eligibility Information System and initiates reduction of benefits when the case is open.  The Claims Specialist pursues repayment and accounts for all payments received on active fraud claims until the overpayments are paid in full.

The most common method of repayment of fraud claims is monthly benefit reduction of current benefits.  Assignment of Permanent Fund Dividends, promissory notes, offsetting federal income tax refunds through the Treasury Offset Program (TOP Treasury Offset Program), and direct monthly payments from the client are other methods of recovering fraud-related overpayments.

The Claims Specialist sends notices to clients making direct payments whenever a payment is received, or if they become delinquent in their payments.  Clients who fail to meet the terms of their repayment agreements may be referred to the Department of Law to have their probation revoked.  The Claims Specialist also garnishees Permanent Fund Dividends to collect delinquent overpayment debts.