218 R.I. Code R. 218-RICR-20-00-1.17

Current through November 7, 2024

Section 218-RICR-20-00-1.17 - Benefit Over Issuances and Claims

A. A recipient claim is an amount owed because of:

1. Benefits that are overpaid, or

2. Benefits that are trafficked.

a. Trafficking is defined as buying or selling of benefit instruments such as EBT cards for cash or consideration other than eligible food.

b. This claim is a Federal debt subject to Rules governing Federal debts.

B. Establishing Claims against Households

1. A claim referral is the identification of a potential over issuance that needs to be investigated and established as a claim by the Claims, Collections and Recovery (CCR) Unit.2. There are three (3) types of claims:

a. Intentional Program Violation (IPV)

(1) Any claim for an over issuance or trafficking resulting from an individual committing an IPV as defined in § 1.9 of this Part when:

(AA) An Administrative Disqualification Hearing official or a court of appropriate jurisdiction has determined that a household member committed an IPV; or

(BB) An individual is disqualified as a result of signing a waiver of her/his disqualification hearing as discussed in § 1.22 of this Part; or

(CC) An individual is disqualified as a result of signing a disqualification consent agreement in a case referred for prosecution as discussed in § 1.22 of this Part.

(2) Claims arising from trafficking-related offenses will be the value of the trafficked benefits as determined by:

(AA) The individual's admission;

(BB) Adjudication; or

(CC) The documentation that forms the basis for the trafficking determination.

(3) Prior to the determination of an intentional program violation or the signing of either a waiver of right to a disqualification hearing or a disqualification consent agreement in cases of deferred adjudication, the claim against the household is handled as an inadvertent household error claim.

b. Inadvertent Household Error

(1) An inadvertent household error is any claim for an over issuance resulting from a misunderstanding or unintended error on the part of the household.

(AA) Claims include only those months of over issuance that have occurred within at least twelve (12) months prior to the date the agency becomes aware of the over issuance.

(2) Instances of inadvertent household error which may result in a claim include, but are not limited to, the following:

(AA) The household unintentionally failed to provide the agency with correct or complete information;

(BB) The household unintentionally failed to report to the agency changes in its household circumstances; or

(CC) The household unintentionally received benefits, or more benefits than it was entitled to receive, pending a fair hearing decision because the household requested a continuation of benefits based on the mistaken belief that it was entitled to such benefits.

c. Agency Error

(1) An agency error is any claim that for an over issuance caused by the agency's action or failure to take action.

(2) Instances of agency error which may result in a claim include, but are not limited to, the following:

(AA) The agency failed to take prompt action on a change reported by the household;

(BB) The agency incorrectly computed the household's income or deductions, or otherwise assigned an incorrect allotment;

(CC) The agency continued to provide a household SNAP allotment after its certification period had expired without benefit of a reapplication determination; or

(DD) The agency failed to provide a household a reduced level of SNAP benefits because its cash assistance amount changed.

(3) The actual steps for calculating an agency error claim are:

(AA) Determine the correct amount of benefits for each month that a household received an over issuance.

(BB) Subtract the correct amount of benefits from the benefits actually received.

(CC) The result is the amount of the over issuance.

(DD) Reduce the over issuance amount by any EBT benefits expunged from the household's EBT benefit account.

(EE) The difference is the amount of the claim.

2. The following individuals are responsible for paying a claim:

a. Each person who was an adult member of the household when the over issuance or trafficking occurred;

b. A sponsor of a non-citizen household member if the sponsor was at fault; or

c. A person connected to the household, such as an authorized representative, who actually traffics or otherwise causes an over issuance or trafficking.

C. When a Claim Cannot Be Established

1. Neither an inadvertent household error claim nor an agency error claim is established if the over issuance occurred as a direct result of the agency's failure to ensure that a household fulfilled the procedural requirements of signing the application form or completing a current work registration form.

D. Determining Initial Month of Over Issuance

1. In all cases involving inadvertent household error or agency error claims, the first (1st) month of over issuance is the month the change would have been effective had it been reported in a timely manner with allowance for the advance notice period.

2. In no instance, however, is the first (1st) month of over issuance any later than two (2) months from the month in which the change in household circumstances occurred.

3. The agency representative determines the initial month of over issuance as follows:

a. Households Subject to Change Reporting Requirements

(1) Failure to Report Change Within Ten (10) Days: If, due to a misunderstanding on the part of the household, the household failed to report a change in its circumstances within ten (10) days of the date the change became known to the household, the first (1st) month affected by the household's failure to report is the first (1st) month the change would have been effective had it been reported in a timely manner.

(2) Change Reported Timely: When a household reports the change on time, but the agency representative does not act on the change in a timely manner, the first (1st) claim month is still the first (1st) month the change would have been effective.

(3) If the Notice of Action was required but not sent, the agency representative assumes, for the purpose of calculating the claim, that the maximum advance notice period would have expired without the household requesting a hearing.

(4) Benefits Issued Pending Hearing Decision

(AA) If a household requests the continuation of benefits pending a fair hearing decision and receives an over issuance because its position is not sustained by the hearing decision, the first (1st) month of over issuance is the month that the change would have been effective had the household not asked for the continuation of benefits.

b. Households Subject to Simplified Reporting Requirements

(1) If the household is a simplified reporting household and the change which resulted in an over issuance of SNAP benefits occurred during the certification period and was not required to be reported, according to the simplified reporting requirements, the over issuance shall be calculated from the date of recertification, which is the time the household was required to report the change.

1.17.1Collection of Claims

A. The agency must initiate collection action against the household on all inadvertent household or agency error claim referrals unless the claim is collected through offset, or one (1) of the following conditions applies:

1. The amount of the claim referral is less than one hundred twenty-five dollars ($125.00), and the claim cannot be recovered by reducing the household's allotment.

a. This threshold does NOT apply for over issuances discovered through the quality control system.

2. The agency has documentation which shows that the household cannot be located.

3. The agency may postpone collection action on inadvertent household error claims in cases where an over issuance is being referred for possible prosecution or for administrative disqualification, and the agency determines that collection action may prejudice the case.

B. A written demand letter entitled, "Demand Letter for Overpayment" is mailed or provided to the household.

1. The claim is considered established as of the date of the initial demand letter or written notification.

2. Repayment Agreement

a. The repayment agreement for any claim must contain due dates or time frames for the periodic submission of payments.

b. The agreement must specify that the household will be subject to involuntary collection action(s) if payment is not received by the due date and the claim becomes delinquent.

c. For all types of claims: agency error, inadvertent household error, and intentional program violation, the household must also be informed:

(1) If the household is participating in the program, that it must repay the entire amount of the claim in cash, check, money order, or funds from an EBT benefit account within ten (10) days of the notice.

(2) If the household does not repay the entire balance, its benefits shall be reduced by the appropriate reduction formula listed in § 1.17 of this Part.

(3) If the household is not participating in the program, it may elect to repay the entire amount of the claim in cash, check, or money order all at once, repay part of the claim, and then repay the rest in weekly or monthly installments.

d. If the household fails to submit a payment in accordance with its repayment agreement, the claim becomes delinquent and is subject to additional collection actions.

3. Any household against which the agency has initiated collection action must be informed of its right to request renegotiation of any repayment schedule to which the household has agreed should the household's economic circumstances change.

4. If the household pays the claim, payment is accepted and submitted to FNS.

C. Households That Fail to Respond

1. If a household against which collection action for repayment of a claim has been initiated is currently participating in the program does not repay the entire over issuance within ten (10) days of the date the notice was mailed, the agency representative initiates action to notify the household of a reduction in its household SNAP allotment by automatic allotment reduction.

2. For a non-participating household which does not respond to the demand letter, additional demand letters are sent on a regular basis.

a. Furthermore, billing notices are sent monthly.

(1) These letters are sent until the household has responded by paying, or agreeing to pay the claim; until the criteria for suspending collection action have been met; or until the agency initiates other collection actions.

3. The agency may also pursue other collection actions, as appropriate, to obtain restitution of a claim against any household which fails to respond to a written demand letter for repayment.

a. If the agency chooses to pursue other collection actions, and the household pays the claim, payments are submitted to the FNS.

b. The agency's retention is based on the actual amount collected from the household through such collection actions.

D. Change in Household Composition

1. The agency must initiate collection action against any or all of the adult members of a household at the time an over issuance occurred.

a. Therefore, if a change in household composition occurs, the agency may pursue collection action against any household which has a member who was an adult member of the household that received the over issuance.

b. The agency may also offset the amount of the claim against restored benefits owed to any household which contains a member who was an adult member of the original household at the time the over issuance occurred.

2. Under no circumstances may the agency collect more that the amount of the claim.

E. Methods of Collecting Claims

1. The agency may collect payment for claims using one (1) of the following methods:

a. Reducing benefits prior to issuance, including allotment reduction and offsets to restored benefits;

(1) SNAP benefits from an EBT account are accepted as partial or full payment of a claim if the household prefers to use this method of repayment.

(2) CCR will automatically collect payments for any claim by reducing the amount of monthly benefits that a household receives.

(3) For an IPV claim, the amount reduced is limited to the greater of twenty dollars ($20.00) or twenty percent (20%) of the household's monthly allotment or entitlement.

(4) For an inadvertent household error or agency error claim, the amount reduced is limited to the greater of ten dollars ($10.00) or ten percent (10%) of the household's monthly allotment.

(5) The agency shall not reduce the initial allotment when the household is first certified.

(6) The agency will not use additional collection methods against individuals in a household that is already having its allotment reduced unless the household voluntarily makes additional payments.

b. Reducing benefits after issuance from electronic benefit transfer (EBT) accounts;

(1) A household is allowed to pay its claim using benefits from its EBT account.

(2) However, the following requirements must be met:

(AA) For collecting from active or reactivated EBT accounts, written permission must be obtained in advance.

(BB) For collecting from stale EBT benefits, written notification must be mailed or otherwise delivered that CCR Unit intends to apply the benefits to the outstanding claim.

(CC) The household must be given at least ten (10) days to notify the agency that it doesn't want to use these benefits to pay the claim.

(DD) For making an adjustment with expunged EBT benefits, the claim must be adjusted by subtracting any expunged amount from the EBT benefit account of which the agency becomes aware.

(EE) A collection from an EBT account must be non-settling against the benefit drawdown account.

c. Accepting cash or any of its generally accepted equivalents, including checks, money orders, and credit or debit cards;

(1) Any payment for a claim is accepted whether it represents full or partial payment.

(2) For non-participating households, the agency accepts installment payments made for a claim as part of a negotiated repayment agreement.

d. Participation in the Treasury Offset Programs (TOP)

(1) § 3701 of the Debt Collection Act, as amended by the Debt Improvement Act of 1996, Pub. Law 104-134, authorizes the U.S. Treasury to collect delinquent claims through what is called Treasury's Offset Programs (TOP).

(2) DHS through the CCR Unit will certify claims to FNS for the purpose of referring delinquent claims for collection by the Treasury.

(AA) In order for this method of collection to be utilized, the CCR Unit must determine that the claim is past due and legally enforceable.

(BB) A claim is considered legally enforceable through the process of the establishment of the claim.

(CC) After reasonable but unsuccessful efforts have been made to collect the claim, it is considered past due.

(3) In order to meet the requirement for Treasury Offset, the claim must be:

(AA) An agency error, inadvertent household error, or intentional program violation;

(BB) At least twenty-five dollars ($25.00) (may be a cumulative amount);

(CC) Delinquent for no longer than ten (10) years and no less than one hundred twenty (120) days unless a debt has been reduced to a final judgment entered by a court ordering the debtor to pay the debt - such debts are not subject to the ten (10) year limit;

(DD) Submitted in the name of one (1) individual or must be reduced by any amount submitted as a separate claim for other individuals who are jointly or severally liable for the claim; and

(EE) Not involved in a bankruptcy stay or discharged in bankruptcy.

(FF) In addition, the agency must notify the individual of the intended action prior to offset and of her or his appeal rights.

(4) The CCR Unit will notify the individual of its intent to refer a claim to Treasury Offset Programs (TOP) and give the individual ninety (90) days to appeal the intended referral by presenting evidence that all or part of the claim is not past due or legally enforceable.

(5) The individual is entitled to appeal the intended referral for offset.

(AA) The appeal request must be in writing and must be received by CCR Unit not later than ninety (90) days after the date of the pre-offset notice.

(BB) The written request for an appeal must include evidence or documentation that the claim is not past due or legally enforceable.

(CC) An appeal is not considered received until the individual provides such evidence or documentation.

(DD) The individual must present her/his Social Security Number as identification with the appeal.

(EE) If the determination is made that the claim does not meet the requirements for offset, in addition to notifying the individual, appropriate corrective action must be taken.

(FF) If DHS decides that the claim meets the requirements for offset, the notice of the review determination of the appeal must state that the agency intends to refer the claim for offset.

(6) After FNS review, if a determination is made that the debt is past due and legally enforceable, the individual will be notified and advised by FNS that they s/he have the right to pursue other appeals through the courts.

(AA) If FNS determines that the claim is not past due and legally enforceable, FNS will request that CCR Unit take any appropriate corrective action.

(BB) The CCR Unit will take any necessary corrective action and will notify the individual of its action.

(7) The agency retains the value of funds collected for inadvertent household error, intentional program violation, or agency error claims.

(AA) This amount includes the total value of allotment reductions to collect claims but does not include the value of benefits not issued as a result of a household member being disqualified.

(BB) The State's letter of credit will be amended on a quarterly basis to reflect the State's retention of twenty percent (20%) of the value of inadvertent household error claims collected and thirty-five percent (35%) of the value of intentional program violation claims collected, as well as full retention by FNS of all agency error over issuance recoveries.

F. IPV Claims

1. If a household member is found to have committed an intentional program violation (by an Administrative Disqualification Hearing official or a court of appropriate jurisdiction), or has signed either a waiver of hearing, or a consent agreement, the agency must initiate collection action against the individual's household.

2. The agency must initiate such collection unless the household has already repaid the over issuance, the agency has documentation which shows the household cannot be located, or the agency determines that collection action may prejudice the case against a household member referred for prosecution.

3. The agency initiates collection action for an unpaid or partially paid claim even if collection action was previously initiated against the household while the claim was being handled as an inadvertent household error claim.

4. In cases where a household member was found guilty of misrepresentation of fraud by a court, or signed a disqualification consent agreement in cases referred for prosecution, the agency requests that the matter of restitution be brought before the court or addressed in the agreement reached between the prosecutor and the accused individual.

G. Overpayment of a Claim

1. If a household has overpaid a claim, the agency must pay the household any amounts overpaid as soon as possible after the overpayment becomes known.

2. The household is paid by whatever method the agency deems appropriate, considering the household's circumstances.

H. Claims Discharged through Bankruptcy

1. The agency acts on behalf of, and as, FNS in any bankruptcy proceeding against bankrupt households owing SNAP claims.

2. The agency possesses any rights, priorities, interests, liens or privileges, and participates in any distribution of assets, to the same extent as FNS.

3. Acting as FNS, the agency has the power and authority to file objections to discharge, proofs of claims, exceptions to discharge, petitions for revocation of discharge and any other documents, motions or objections which FNS might have filed.

I. Interstate Claims Collection

1. When a household moves out of the area under the agency's jurisdiction, the agency should initiate or continue collection action against the household for any over issuance to the household which occurred while it was under the agency's jurisdiction.

2. The agency which overpaid benefits to the household has the first (1st) opportunity to collect any over issuance.

a. However, if the agency which overpaid benefits to the household does not take prompt action to collect, then the agency which administers the area into which the household moves should initiate action to collect the over issuance.

b. Prior to initiating action to collect such over issuance, the agency which administers the area into which the household moves must contact the agency which overpaid benefits to ascertain that it does not intend to pursue prompt collection.

1.17.2Delinquent Claims

A. A claim must be considered delinquent if:

1. The claim has not been paid by the due date and a satisfactory payment arrangement has not been made, or:

a. The date of delinquency in this instance is the due date on the initial written notification or demand letter.

b. The claim remains delinquent until payment is received in full, a satisfactory payment agreement is negotiated, or allotment reduction is imposed; or

2. A payment arrangement has been established and a scheduled payment has not been made by the due date.

a. In this instance, the date of delinquency is the due date of the missed installment payment.

b. The claim remains delinquent until payment is received in full, allotment reduction is imposed, or if the CCR Unit decides to either to resume or re-negotiate the repayment schedule.

B. A claim is not considered delinquent if another claim for the same household is currently being paid either through installment agreement or allotment reduction and the CCR Unit expects to begin collection on the claim once the prior claim(s) is settled.

C. A claim awaiting a hearing decision is not considered delinquent.

1. If the hearing officer determines that a claim does, in fact, exist against the household, the household must be re-notified of the claim.

2. Demand for payment may be combined with hearing decision letter.

3. Delinquency must be based on the due date of this subsequent notice and not the initial pre-hearing demand letter sent to the household.

4. If the hearing officer determines that a claim does not exist, the claim is disposed of in accordance with § 1.17.4 of this Part.

1.17.3Compromising Claims

A. The CCR Unit may compromise a claim or any portion of a claim if it can be reasonably determined that a household economic circumstances dictate that the claim will not be paid in three (3) years.

1. The full amount of the claim (including any amount compromised) may be used to offset benefits owed to the household in accordance with § 1.17.5 of this Part.

2. Any compromised portion of a claim may be reinstated if the claim becomes delinquent.

1.17.4Terminating and Writing-Off Claims

A. A terminated claim is a claim in which all collection action has ceased. A written- off claim is no longer a receivable subject to Federal and State agency collection and reporting requirements.

1. If a claim is determined to be invalid, the claim must be discharged and reflected as a balance adjustment rather than a termination unless it is appropriate to pursue the over issuance as a different type of claim (e.g., as an inadvertent household error rather than an Intentional Program Violation claim).

B. Claims must be terminated and written off, when:

1. All adult household members are deceased;

2. The claim balance is twenty-five dollars ($25.00) or less and the claim has been delinquent for ninety (90) days or more unless other claims exist against this household resulting in an aggregate claim total of greater than twenty-five dollars ($25.00);

3. It is not cost effective to pursue the claim any further;

4. The claim is delinquent for three (3) years or more, unless it is planned to pursue the claim through Treasury's Offset Program; or

5. The household cannot be located.

C. A terminated and written-off claim may be reinstated if a new collection method or a specific event (such as winning the lottery) substantially increases the likelihood of further collection.

1.17.5Offsetting Claim Prior to Restoring Benefits

A. When calculating the amount of the claim, any amount of under issuance not yet restored in accordance with § 1.18 of this Part, must be offset against the claim. The agency then institutes collection action for the remaining balance.

1. When there is any restoration of lost benefits which is used to offset an established claim, the balance of the claim is reduced by the amount of the offset.

B. For each month that a household received an over issuance due to an act of intentional program violation, the agency must determine the correct amount of SNAP benefits, if any, the household was entitled to receive.

1. The amount of an intentional program violation claim is calculated back to the month the act of intentional program violation occurred, regardless of the length of time that elapsed until the determination of intentional program violation was made.

a. However, the agency must not include in its calculation any amount of the over issuance which occurred in a month more than six (6) years from the date the over issuance was discovered.

2. If the household received a larger allotment than it was entitled to receive, the agency representative must establish a claim against the household equal to the difference between the allotment the household received and the allotment the household should have received.

a. When determining the amount of benefits the household should have received, the agency representative must not apply the twenty percent (20%) earned income deduction to earned income which the household failed to report in a timely manner in accordance with the household's change reporting requirements.

3. If the household member is determined to have committed an intentional program violation by failing to report a change in the household's circumstances, the first (1st) month affected by the household's failure to report is the first (1st) month in which the change would have been effective had it been reported.

a. In no instance, however, is the first (1st) month of over issuance any later than two (2) months from the month in which the change in household circumstances occurred.

218 R.I. Code R. 218-RICR-20-00-1.17

Amended effective 4/4/2019
Amended effective 12/24/2019
Amended effective 8/1/2021
Amended effective 9/23/2021
Amended Effective 12/4/2021
Amended effective 11/10/2022
Amended effective 1/1/2023
Amended effective 5/14/2023
Amended effective 10/1/2023
Amended effective 12/15/2023
Amended effective 9/22/2024
Amended effective 10/1/2024
Amended effective 10/24/2024