1850 Claim Disposition Options for Fraud Claims | FPRU
Department of Human Services |
Index: |
POL 1850 |
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Revised: |
01/27/2023 |
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Next Review: |
01/26/2025 |
Policy
One of the primary goals of the Office of Inspector General (OIG) is to seek final adjudication and disposition of intentional program violation claims by judicial or administrative means.
Options for adjudication through the judicial process:
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Criminal prosecution
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Consent Agreement
Options for adjudication through the administrative process:
Adjudication through administrative processes allows recipients who have intentionally obtained excess benefits to be administratively adjudicated and make restitution without going through the court system. Currently, there are two mechanisms for administrative adjudications:
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Administrative disqualification hearing
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Waiver of disqualification hearing
Non-adjudications:
Recovery of overpayments through administrative means allows recipients who have obtained excess benefits to make restitution without adjudication. Currently, there is one mechanism:
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Non-fraud claim
Definitions
A claim is a debt that the state must collect regardless of the claim type. Claims are created when an assistance unit receives more benefits than it is eligible for or does not receive all the benefits it is entitled to. A claim is not considered complete until it is brought to a final claim disposition and the claim is authorized.