Nebraska Administrative Code › Topic - HEALTH AND HUMAN SERVICES SYSTEM › Title 475 - SUPPLEMENTAL NUTRITION ASSISTANCE PROGRAM › Chapter 4 - BENEFITS › Section 475-4-007 - COLLECTIONS

Current through June 17, 2024
This section detail the responsibilities and guidelines in regard
	 to:
(A) Establishing overpayments and
  accounts receivable; and
(B)
  Collections on accounts receivable.
007.01
ESTABLISHING
  OVERPAYMENTS.
Thresholds have been established to determine
  whether or not to create an accounts receivable against a certified or
  non-certified household. The thresholds are determined by how the error was
  determined and whether or not the household is certified at the time the
  overpayment is discovered. Accounts receivable are established for:
(1) All overpayments determined by Quality
  Control;
(2) Certified households
  when the cumulative amount of the overpayment is $25 or more;
(3) Non-certified households when the
  cumulative amount of the overpayment is $125 or more; and
(4) The amount of the threshold for each type
  of household is applied at the time the overpayments are calculated.
007.01(A)
TYPES OF
  OVERPAYMENTS.
There are three types of overpayments:
(i) Administrative Error Overpayment: Any
  overpayment caused by the Department's action or failure to take action;
(ii) Inadvertent Household Error
  Overpayment: Any overpayment caused by a household's misunderstanding or
  unintended error; and
(iii)
  Intentional Program Violation Overpayment: Any overpayment caused by an
  Intentional Program Violation as adjudicated by:
(1) A disqualification hearing;
(2) A court of appropriate jurisdiction;
  or
(3) A household's signing of a
  waiver of the individual's right to a disqualification hearing.
007.01(B)
CRITERIA FOR ESTABLISHING ADMINISTRATIVE ERROR
  OVERPAYMENTS.
An overpayment will be established against any
  household that received an overpayment due to an Administrative Error within
  the last 12 months before the month of discovery. Action may be taken on an
  overpayment for which more than 12 months have elapsed; however, action cannot
  be taken on overpayments for which more than six years have elapsed between the
  month an overpayment occurred and the month the overpayment was discovered.
  Instances of Administrative Error include, but are not limited to:
(i) Income, resources, or deductions which
  were computed incorrectly or otherwise caused an incorrect benefit
  amount;
(ii) Action that was not
  taken timely based on information known to the agency or reported by the
  household;
(iii) When incorrect
  policy or procedure was applied; or
(iv) When duplicate benefits were issued in
  error.
007.01(C)
CRITERIA FOR ESTABLISHING INADVERTENT HOUSEHOLD ERROR
  OVERPAYMENTS.
An overpayment will be established against any
  household that received an overpayment due to an Inadvertent Household Error
  within the last 12 months before the month of discovery. Action may be taken on
  an overpayment for which more than 12 months have elapsed; however, action
  cannot be taken on overpayments for which more than six years have elapsed
  between the month an overpayment occurred and the month the overpayment was
  discovered. The following are the most common overpayment situations caused by
  inadvertent household errors:
(i) Household
  misunderstanding or an unintended error resulting in the household either
  reporting incorrect information or failing to report information or changes;
  or
(ii) Household receiving
  continued benefits pending a fair hearing and the agency's decision was upheld.
007.01(D)
CRITERIA FOR ESTABLISHING INTENTIONAL PROGRAM VIOLATION
  OVERPAYMENTS.
Potential Intentional Program Violations will be
  reported to the Special Investigations Unit of the Department. Until a
  determination of an Intentional Program Violation has been made, the Accounts
  Receivable is processed as an Inadvertent Household Error.
007.01(D)(i)
OVERPAYMENT
  PROCESSING PROCEDURES.
In situations where a potential Intentional
  Program Violation may have occurred, overpayments are calculated back to the
  month the alleged Intentional Program Violation occurred up to six years from
  the date of discovery. If the alleged Intentional Program Violation was caused
  by the household's failure to report information timely, the overpayment will
  be calculated beginning with the month the change would have been effective if
  it had been reported in a timely manner. The first month of the overpayment
  cannot be more than two months after the change occurred.
007.01(E)
TRAFFICKED
  BENEFITS.
Overpayment amounts of trafficked benefits will be
  established based on reports from Food and Nutrition Service, Office of
  Inspector General or the Department of Health and Human Services Special
  Investigations Unit. Overpayments based upon trafficking or attempted
  trafficking of Supplemental Nutrition Assistance Program benefits will be
  established using the individual's admission, the adjudication, or the evidence
  of trafficking which may include evidence obtained from social media
  sites.
007.01(F)
SITUATIONS WHEN OVERPAYMENTS ARE NOT ESTABLISHED.
An
  overpayment is not established when:
(i) The
  agency failed to ensure that the household signed the application
  form;
(ii) A categorically eligible
  or an Expanded Resource Program eligible household has been overpaid benefits
  and there has been no change in the net income and/or household size;
(iii) The household is receiving
  benefits and the accumulated months of Inadvertent Household Error and/or
  Administrative Error overpayments total less than $25 and Quality Control or
  the Special Investigations Unit did not discover the error; or
(iv) The household is not receiving benefits
  and the accumulated months of Inadvertent Household Error and/or Administrative
  Error overpayments total less than $125 and Quality Control or the Special
  Investigations Unit did not discover the error.