CLAIMS HANDBOOK - Department of Human Services

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BENEFIT RECOVERY (CLAIMS) HANDBOOK Ongoing Claims Management Collection Methods 21 Manual Payments 21 - 23 Benefit Reduction 23 - 25 Underpayment Offset 25 EBT Accounts 26 State Tax Offset 27 Federal Benefit Offset 28 - 29 Innocent Spouse 30 Updating / Correcting Fiscal Records 31 - 34 Over-collection of Claims / Payments to be Refunded 35 - 37 Transferring Claims 38 - 39 Termination of Uncollectible Claims 40 Purging Claim Files 40 Bankruptcy 41 - 42 IPV Disqualifications 43 - 45 Disqualified Recipient Subsystem (DRS) 46 - 47 Fair Hearings and Claims 48 SUCCESS Reports as Management Tools 49 - 52 Retention of Reports 52 Appendix A 53 - 67 Rev December ‘10 4
BENEFIT RECOVERY (CLAIMS) HANDBOOK Overview of Benefit Recovery Benefit errors occur when an Assistance Unit (AU) receives an incorrect benefit amount in the Food Stamp, Temporary Assistance for Needy Families, Child Care or Refugee Assistance Program. Federal and State regulations provide for the mandated recovery of over-issued benefits or the restoration of under-issued benefits. Benefit errors are generally caused by: • A customer unintentionally providing inaccurate or incomplete information • A customer deliberately providing incomplete or inaccurate information • A case manager failing to take action on known information • A case manager miscalculating benefit entitlement In the programs supported by SUCCESS, errors must be corrected by: • Invalidating the benefit error if unsupported by verification, case documentation, policy or if it meets fiscal criteria • Validating the error by issuing an underpayment (UP) or establishing a claim • Referring the suspected program violation to the Office of Program Integrity and Compliance (OPIC) The Office of Family Independence Policy Manual provides policy to determine the validity of benefit errors. The Benefit Recovery portion of the Office of Family Independence Policy Manual (Volume IV) is a specific guide to the management of benefit errors. The SUCCESS User Manual provides instructions for the automated tracking and reporting of benefit errors and recoveries. The Field Fiscal Services Policy and Procedures Manual provides guidelines for managing the recovery of and ensuring the fiscal integrity of recovered funds in the county. The Claims Handbook provides the County and State with established procedures for claims management. Claims management includes monitoring the management reports produced by SUCCESS as well as claims file maintenance and customer service to those whose claims we manage. It also includes working with state and other county personnel to assure that we recover all that is due but no more, and that we complete this task while allowing the debtor to maintain dignity. Rev December ‘10 5
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CLAIMS HANDBOOK - Department of Human Services

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