Conn. Agencies Regs. § 16a-41(b)-13

Current through October 16, 2024

Section 16a-41(b)-13 - Fraud early detection, fraud investigation, recoupment of overpayment(s) and vendor fraud

(a)Identification and reporting of overpayment(s):

(1) All overpayment(s) will be referred to the Department; and

(2) Any service provider agency referring any overpayment(s) to the Department shall indicate whether, in its judgment, the overpayment was caused by the applicant/service recipient or by agency error.

(b)Recoupment of overpayment(s):

(1) An overpayment(s) which occurs through the error of a service provider agency shall be fully reimbursed by the service provider agency from funds which are not derived from state or federal governments.

(2) An overpayment(s) which results from the provision of Type I Crisis Assistance to ineligible households shall be reimbursed by the applicant household. The total amount of Type I Crisis Assistance shall be repaid by the applicant to the service provider agency within ninety (90) days of receipt of the Notice of Repayment.

(A) The applicant household shall be:

(i) provided with a Notice of Ineligibility from the service provider agency; and

(ii) provided with a Notice of Repayment from the service provider agency which states the amount to be repaid.

(B) If no payment is received from the applicant household after ninety (90) days from the postmarked date of the notice of repayment, the service provider agency shall notify the Department in writing.

(C) Upon receipt of said notification, the Department shall re-notify, in writing, the applicant household of the amount to be repaid. Repayment is to be made to the service provider agency within thirty (30) days of the postmarked date of this final notice. The Department shall make every reasonable effort to recoup the overpayment(s).

(3) An overpayment(s) resulting from error, misrepresentation or fraud by service recipient households shall be fully reimbursed by the service recipient households. The Department shall provide written notification to the service recipient household and service provider agency as to the decision regarding the overpayment(s) and the amount to be repaid. No further assistance shall be provided to the service recipient household in the current program year. In addition, the household is prohibited from participation for a period of two (2) program years following the year in which the offense occurred.

(c)Vendor fraud

Vendors convicted of program fraud, misrepresentation, or a violation of any aspect of their agreement with the energy assistance program, are subject to prosecution and indefinite suspension from the program. Vendors suspected of fraud may be suspended during the pendency of legal proceedings.

(d)Fraud early detection and fraud investigations

(1) The applicant or service recipient shall cooperate with the Department's fraud early detection (FRED) program and with any fraud investigation by completing all required forms, cooperating and participating in home visits by FRED investigators, responding to interview appointments and by making all requested records or information available to the Department. The applicant or service recipient who does not cooperate may be determined to be ineligible until they do cooperate.

(2) Service provider agencies shall make referrals to the Department on applications that meet FRED criteria, as determined by the Department.

Conn. Agencies Regs. § 16a-41(b)-13

Effective July 1, 1993; Amended March 7, 2007