Addendum 109 E - Fraud Referral and Findings CANO Template

ADMINISTRATIVE PROCEDURES MANUAL

ADDENDUM 109 E

FRAUD REFERRAL AND FINDINGS CANO Case Notes TEMPLATE

DOCUMENTING FRAUD REFERRALS

Caseworkers must follow the procedure outlined in Administrative Manual section 112-4 in making referrals of suspected fraud cases. In addition to completing the necessary forms to refer cases to Fraud Unit, caseworkers must also document concisely on CANO Case Notes all referrals made to Fraud Unit. The documentation must include the following information:

SUBJECT	ELEMENTS
RECORD TITLE:	Fraud Referral

FACTS OF CASE:	In narrative form, address each of the following: Reason for referral Program(s) and eligibility factor(s) affected by the allegation Possible benefit months affected by allegation Form completed and submitted to Fraud Unit (Gen 97a / Gen 40), and date of submission

DOCUMENTING FRAUD FINDINGS

Caseworkers must also document in CANO Case Notes the report and findings received from Fraud after an investigation is made. Immediately after receiving the Early Fraud Findings Report (GEN 97b) or FCU Fraud Control Unit #5, the caseworker must take action and document the findings on CANO Case Notes . The documentation must include the following information:

SUBJECT	ELEMENTS
RECORD TITLE:	Fraud Findings for Referral made on (date of referral)

FACTS OF CASE:	In narrative form, address each of the following: Summary of fraud report Action taken on case resulting from fraud findings Additional forms completed as a result of the fraud findings (ex. Gen 95 form if overpayment occurred)

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		2012-02 (11/12)