Section 16a-41-41 - Fraud and overpayment(a) Identification and Reporting of Overpayment(s):(1) All overpayment(s) will be referred to the Department of Human Resources; and,(2) Any service provider agency referring any overpayment to the Department of Human Resources shall indicate whether, in its judgment, the overpayment was caused by the withholding of information, or agency error.(b) Recoupment of Overpayments (1) Recoupment of administrative overpayment(s) shall be 100% of all such overpayment reimbursed by the service provider agency from locally generated funds at a rate to insure full restitution of all overpayments by the end of the annual program period.(2) Recoupment of overpayments resulting from willful withholding of information by applicant/service recipients; (A) Where an overpayment is caused by the household's willful withholding of information the recoupment of said overpayment shall be made from the household's available income, excluding income as defined in Section 16a-41-34(m) (1).(B) Upon receipt of those cases referred to the Department of Human Resources in which an allegation of willfulness has been made, a determination will be made, by the Department, as to whether or not the cases will be recommended for prosecution. When the determination is not to pursue prosecution, the Department of Human Resources will initiate the following recoupment process.
(i) The Department of Human Resources will notify the service provider agency and the household of its decision concerning said overpayment.(ii) The Department of Human Resources will remand the case to the service provider agency for the discontinuance of further assistance to the household, and the development, with the subject household, of an amortization agreement for full repayment of the overpayment(s) by September 30 of the program year in which the willful withholding occurred.(iii) In every instance in which the Department of Human Resources remands a case to a service provider agency or finds against a service provider agency and proposes to recoup, advance notice shall be given, in writing, stating the nature of the overpayment(s) and the amount(s) due. The household or service provider agency will also be advised of their right to appeal the decision within seven (7) days of receipt of the notice.(C) Fraud and Suspected Fraud (i) All fraud and suspected fraud will be referred in writing to the Department of Human Resources.(ii) Any service provider agency referring any fraud or suspected fraud will indicate the nature of the fraud being reported.(iii) Any assistance paid on behalf of any household as a result of fraud may be recovered in an action brought against the applicant for the household or the service provider agency.(iv) Any applicant/service recipient who perpetrates any fraud or persons who aid and abet in the perpetration of any fraud, to obtain assistance under these regulations, shall be subject to the penalties under these regulations, shall be subject to the penalties for larceny established under Sections 53a-122 to 53a-125 of the Connecticut General Statutes, inclusive, depending upon the amount involved.(v) Persons who misrepresent their circumstances in applying for assistance are subject to prosecution and recoupment of any benefits provided, and may be prohibited from participation for a period of two program years following the year in which the offense occurred. Clients who divert benefits to ineligible persons are subject to the same penalties, following proper due process. (iv) Vendors committing fraud, misrepresentation, or a violation of any aspect of their agreement with the service provider agencies are subject to prosecution, and prohibition from the program for up to five years following the program year in which their offense occurred, upon conviction. Vendors suspected of fraud may be suspended from participation in the weatherization program during the pendency of legal proceedings.Conn. Agencies Regs. § 16a-41-41
Effective August 25, 1986