Overpayments: Disqualifications and Monetary Penalties

An important part of the claim establishment process is determining who is at fault. A claim is either the result of a DHS or household error. A household error claim may occur unintentionally through an honest mistake, or intentionally through misrepresentation of facts or fraud. SNAP and TANF household errors with fraudulent intent are called Intentional Program Violations (IPV). Although overpayments may be classified as fraudulent in all AFS programs, the SNAP program is the only program in which a client can be disqualified due to fraud. If fraud occurs in TANF it is the only program where a monetary penalty is applied. In some instances a client may be disqualified or penalized, but not have an overpayment claim.

Depending on the offense committed by the individual, as well as number of previous disqualifications / penalties, the time frame for the sanction can range from 12 months to permanently. If an individual has two disqualifications where the time periods overlap, the disqualifications are served concurrently, not consecutively. Fraud determinations are made by the Office of Inspector General (OIG) and one of four things must happen for a claim to be considered as an IPV/Fraud:

  • The client signs an Administrative Disqualification Hearing (ADH) Waiver
  • An Administrative Disqualification Hearing (ADH) decision is not found in the client’s favor
  • A court order assigns the classification
  • A Disqualification Consent Agreement (DCA) is signed

The disqualifications are processed by Benefit Integrity and Recovery (BIR) when OIG closes the investigation. BIR staff is responsible for updating the PS2/IMS case by removing the disqualified individual from the benefit and / or closing the section, inserting a case note into FACS, updating the national disqualification database and mailing official notification to the client. Once BIR has entered the disqualification information into the national disqualification database, it can be viewed by typing FSD SSN of the disqualified person and an edit should generate when someone attempts to add the individual to a SNAP or TANF benefit. The edit text advises that BIRS can be contacted at 405-522-0933 and it is imperative the county contact us if the disqualification did NOT occur in Oklahoma because we are required to verify the validity of the disqualification. Although the edit should generate whether the disqualification occurred in Oklahoma or another state, you can clear the edit if the disqualification occurred in Oklahoma by coding the individual as ‘income/resources are considered in benefit computation; individual not included’ (F25=O) and reason as ‘fraud disqualification for SNAP or TANF’ (F26=14) If you aren’t sure about the coding or have questions or concerns about the disqualification, please contact BIR. If you receive the edit and discover the disqualification occurred in another state, please contact BIR as soon as possible. Per federal regulation, we must obtain secondary verification from that state about the SNAP disqualification and specific documents are required from the imposing state for the verification process. It is the responsibility of BIR to contact the other state to verify the disqualification when we have been alerted by the county receiving the edit. Likewise, if you receive phone calls from other states requesting verification of Oklahoma disqualifications it is VERY IMPORTANT to refer the caller to email BIR or 405-522-0933.

The Food and Nutrition Service (FNS) is currently in the process of setting up a national contact list of individual(s) responsible for this task from each state and as already indicated the point of contact for secondary verifications in Oklahoma is BIR. DHS field employees don’t have the time or correct documentation to respond to these inquiries and providing verification to another state(s) based on the FSD screen is never appropriate.

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