4010 Intentional Program Violations

Georgia State Seal

GEORGIA DIVISION OF FAMILY AND CHILDREN SERVICES
BENEFIT RECOVERY POLICY MANUAL

Chapter:

4010

Effective Date:

December 2019

Policy Title:

Intentional Program Violations

Reviewed or Updated in:

MT-11

Policy Number:

4010

Previous Update:

MT-10

Requirements

Refer suspected intentional program violation (IPV) via Form 5667 (Request for Case Review), within 30 days of identifying the potential benefit error. One form may be utilized for multiple programs. Attach supporting documents to the request and forward it to the Office of Inspector General (OIG) within 10 days of completion. The date of the request is the date entered on Form 5667.

A Request for Case Review for investigation can also be made by completing a request in the IPV Referral Search in the submodule in Georgia Gateway.

OIG conducts investigations using standard, approved investigative techniques and determines if a loss exists, amount of loss and method of adjudication.

Claims calculated by OIG are established manually. OIG has up to 12 months from the date of the request to complete investigation, determine if an overpayment exists and establish a claim.

OIG will approve a non-fraud claim if the information is not sufficient to process the IPV or if the intent to commit fraud cannot be proven.

Procedures

Complete the Request for Case Review (Form 5667) manually or in Georgia Gateway.

Discuss the suspected intentional program violation with the recipient and document the recipient’s response. Additional verification may be requested to determine ongoing eligibility. Correct benefits for ongoing months only. The correction of prior months is OIG’s responsibility. Do not change data in any historical month unless the change is unrelated to the suspected IPV.

OIG will enter disqualifying information in Georgia Gateway for the Food Stamp Program for its investigations. This information is electronically transmitted to eDRS (Electronic Disqualification Recipient System).

OIG will enter disqualification information on TANF cases in Georgia Gateway for its investigations.