N.Y. Comp. Codes R. & Regs. tit. 18 § 348.2

Current through Register Vol. 46, No. 45, November 2, 2024

Section 348.2 - Required district procedure

Each social services district shall take these measures designed to prevent, detect and report fraud:

(a) Establish and maintain clear and adequate policies, procedures and controls in order to effectively handle cases of suspected fraud in the administration of public assistance and care.

(b) Make an agreement with the appropriate district attorney or other prosecuting official establishing the procedures for referral to such official of all cases wherein reasonable grounds exist to believe that fraud was committed.

(c) File with the department a copy or a statement of the agreement with the prosecuting official.

(d) Designate a person, either of administrative or supervisory responsibility or in a consultative capacity to the local district such as a welfare attorney, or establish a unit which shall consist of persons of similar responsibility, to which all cases of known or suspected fraud shall be referred, to perform the following functions:

(1) review district material referred, including any that may be legal evidence;

(2) determine whether that material indicates that reasonable grounds exist to believe that fraud was committed by the applicant or recipient and/or others;

(3) in cases of suspected fraud, when the material referred and reviewed does not indicate that reasonable grounds exist to believe that fraud was committed, but when such material is insufficient to erase suspicion of fraud, decide whether further investigation may produce evidence necessary to determine that reasonable grounds exist or erase the suspicion, and conduct the investigation;

(4) determine the existence of any mitigating facts or circumstances;

(5) promptly refer to the appropriate district attorney or other prosecuting official all cases wherein reasonable grounds exist to believe that fraud was committed, in accordance with such procedures as may be developed locally between the social services official and district attorney or other prosecuting official, which procedures may, to avoid duplication of referrals, merely require the social services department to identify cases already referred to the district attorney by the inspector general with the knowledge of that office and to transmit to the district attorney on a continuing basis, all material pertinent to the prosecution of such cases which may supplement the material already transmitted by the inspector general. Any existing mitigating facts or circumstances known to the department shall be included in the referral;

(6) maintain liaison with such appropriate district attorney or other prosecuting official and endeavor to secure reports of actions taken with respect to cases referred;

(7) promptly advise the appropriate district attorney or other prosecuting official whenever restitution, or arrangements for restitution of fraudulently received public assistance funds has been made, or is being made.

N.Y. Comp. Codes R. & Regs. Tit. 18 § 348.2