La. Admin. Code tit. 67 § III-5106

Current through Register Vol. 50, No. 11, November 20, 2024

Section III-5106 - Ineligible Payments

A. All ineligible benefits are subject to action to recover such benefits with the exception of inadvertent household error claims and administrative error claims of $125 or less for non participating households.

B. Action will be taken to recover all claims for participating households, all claims which are determined to be the result of intentional program violation (IPV), and all claims resulting from errors which are discovered in a quality control review.

C. When a participant is suspected of IPV, appropriate referral and forms shall be submitted to the Fraud and Recovery Section. The Fraud and Recovery Section may then:

1. refer the case for prosecution; or

2. refer the case to the Appeals Bureau for a disqualification hearing if the participant does not sign the waiver of right to an administrative hearing and the facts of the case do not warrant civil or criminal prosecution through the appropriate court systems; or the case was previously referred for prosecution and was declined by the appropriate legal authority; or the case was previously referred for prosecution and no action was taken within a reasonable period of time and the referral was formally withdrawn by Fraud and Recovery.

D. If IPV is established, Fraud and Recovery will send a notice to the person to be disqualified and a copy of the notice to the local DCFS office. The local DCFS office will take action to disqualify for the appropriate situations:

1. 12 months for the first violation;

2. 24 months for the second violation; and

3. permanently for the third violation.

La. Admin. Code tit. 67, § III-5106

Promulgated by the Department of Children and Family Services, Economic Stability and Self-Sufficiency Section, LR 36:2535 (November 2010), amended by the Department for Children and Family Services, Economic Stability Section, LR 39:2192 (August 2013).

AUTHORITY NOTE: Promulgated in accordance with 45 CFR Parts 98 and 99, P.L. 104-193, and Act 58, 2003 Reg. Session.