Part 7 Overpayments and Fraud

Transcription

1 Part 7 Overpayments and Fraud 101 What if I was overpaid SNAP benefits? If you get more SNAP benefits than you are eligible for, DTA can recover the overpayment. 106 C.M.R An overpayment can happen because DTA made a mistake, you made a mistake, or because you got SNAP benefits while you were waiting for a hearing and you then lost the hearing. These mistakes are considered Unintentional Program Violations (UPVs) or Agency Errors (AE). 106 C.M.R See Question 102. The overpayments include recovery of benefits that you got while you were waiting for a hearing decision and you lost the appeal. 106 C.M.R If DTA thinks the overpayment happened because you committed an intentional program violation (IPV) or fraud, see Question 103. If you have an overpayment, but are no longer receiving SNAP benefits, DTA will not try to recover a UPV or AE overpayment unless it is $125 or more. 106 C.M.R If you are receiving SNAP, DTA will try to recover the overpayment from your ongoing SNAP benefits. See Questions 108 and 109. How does DTA calculate the amount of the overpayment? For an overpayment that happened by mistake, DTA calculates the difference between what you got and what you should have received in SNAP. So, for UPV and Agency Error overpayments, DTA should include all applicable income deductions (20% earned income, child care, shelter costs, medical expenses, etc.) in determining the amount of overpayment. 106 C.M.R (D). For IPV (fraud) errors, the SNAP rules do not allow DTA to use the 20% earnings deduction from earned income. Food Stamp/SNAP Advocacy Guide 2017 February 2017 Page 201

2 For all overpayments, the first month of an overpayment is the month the change would have been effective if it had been reported by you timely, or acted on by DTA timely. 106 C.M.R (D), (A). Federal regulations also require DTA to calculate the amount of an overpayment by doing a month to month calculation not by averaging out an amount of income over the period of the overpayment. 7 C.F.R (c)(ii)(A). Example: Jane Smith started a job in mid-june. She was not sure the job would last when she filled out her Interim Report a week later, because her employer told her the job was just for two weeks as a fill-in for a sick employee. As it turns out, Jane s job continued for 4 more months and he increased her hours. Jane was paid $4,250 over the months she worked about $200 in June, $500 in July, $1,000 in August, $2,050 in August (she worked over time) and $500 early September. Jane called DTA the end of August when her income exceeded the gross income test. She explained what happened that she thought the job was temporary when she filled out the form) and reapplied. DTA agreed with Jane this was an unintentional program violation (UPV) but she was still overpaid DTA should not average the $4,250 over the 4 months (at $1,000/month). Jane was not overpaid in June (because DTA would not have acted on the income until July). She was still eligible for some SNAP in July and September but over the gross income test August. Each month overpayment should be calculated separately. What if DTA expunged benefits or owes you SNAP DTA should reduce the amount of an overpayment by any amount of SNAP they know has been expunged (taken away due to lack of use for over 365 days). 7 C.F.R (c)(ii)(C). DTA should also reduce the overpayment by any underpayment of SNAP benefits that DTA owes you. 106 C.M.R Contact a legal advocate if you are worried DTA did not do this when calculating your overpayment. Advocacy Reminders: Ö If DTA says you were overpaid, you can appeal. See Question 94. You can also ask DTA to send you a copy of the overpayment packet (overpayment information) in your case. If you think DTA made a mistake in the overpayment amount you should tell them.

3 Ö There is no overpayment if you did not report a change that you were not required to report or would not matter. For example if you were on Simplified Reporting and you did not report an increase in income in between Interim Reports, there is NO overpayment unless the increase put your household over the gross income limit. See Question 89. There is also NO overpayment if you did not report information that would not have affected your SNAP. For example, if your 16 year old high school student started working or you started to get Work Study this income is considered non-countable. See Question 60. DTA Policy Guidance: Online Guide Sections: Home > Cross Programs > Overpayment and Recovery 102 Do I have to repay an unintentional overpayment? Usually yes. Even if the overpayment happened because you or DTA mistake, DTA will try to recover overpayment unless you meet certain exceptions. 106 C.M.R (E) But DTA does not seek recovery when: n More than 12 months have passed since DTA discovered the overpayment, n The overpayment is less than $125 and you are not a current recipient, In most other cases, DTA will try to recover the overpayment even though you did not commit fraud or even if it was DTA s fault. If you are currently receiving SNAP, DTA can deduction a portion of your SNAP to repay the overpayment, or they can reduce the claim. See Question 108. However, DTA has the authority to reduce the claim to the amount that can be recovered in three (3) years. This is called compromising the claim. 106 C.M.R (F). DTA also has the authority to waive the entire claim under certain circumstances. 7 C.F.R (b), 7 C.F.R (e)(7). For example, if pursuing a claim (especially an agency error Food Stamp/SNAP Advocacy Guide 2017 February 2017 Page 203

4 or UPV) would cause severe economic hardship to you, or it would be costly for DTA to pursue the claim. If you are not currently receiving SNAP, DTA can also waive or suspend collection if your household is not currently receiving SNAP and DTA determines that the cost of collection will be more than DTA is likely to recover or would be unfair. 106 C.M.R (H). You have the option to ask DTA to compromise your claim if you cannot pay it without hardship. Contact Legal Services if you need help trying to compromise a SNAP overpayment. DTA Policy Guidance: Online Guide Sections: Home > Cross Programs > Overpayment and Recovery > Unintentional Program Violations 103 What if DTA says I committed fraud or an Intentional Program Violation (IPV)? An IPV is an intentional program violation. That is when a court or hearings officer determines that you gave DTA false or misleading information on purpose, willfully hid information in order to get benefits you are not eligible for, or intentionally did not report a change that you were required to report and would have reduced your benefits. 106 C.M.R Purposely giving false or misleading information or willfully hiding information in order to get benefits is fraud. How is the intentional overpayment calculated? For an overpayment that was due to purposely misleading DTA (intentional program violation), DTA calculates the difference between what you got and what you should have gotten after allowing all applicable deductions, but you will not get the 20% earned income deduction off your earned income. 106 C.M.R (A). The first month of an overpayment is the month the change would have been effective if it had been reported on time. 106 C.M.R (D), (A).

5 DTA cannot claim any benefits issued more than six years before it became aware of the overpayment. 106 C.M.R , (A). Under federal rules, DTA is supposed to establish the claim no later than the quarter after the quarter DTA discovered the overpayment. 7 C.F.R (d)(1). 104 What is DTA required to do to show I committed fraud? DTA must give you written notice of the SNAP intentional program violation (IPV) penalties each time you apply. The notice must be in English, Spanish or other languages spoken by 100 or more households in the area served by the DTA office. 106 C.M.R Question 21. To establish an IPV, DTA has to prove that you knew the SNAP rules and your responsibilities and that you purposely violated the rules. DTA must prove with clear and convincing evidence that you willfully, knowingly and with deceitful intent committed an IPV. 106 C.M.R Simple unintentional mistakes or misunderstandings between you and your worker that result in an overpayment are not IPVs. In calculating the amount of the overpayment, DTA must give you all the deductions (shelter, child care) you would otherwise receive, with the exception of the 20% earned income deduction. 106 C.M.R (A). Be sure to contact an advocate if you are notified of an IPV or administrative disqualification hearing. The following are examples from hearing decision findings that DTA did not meet its burden to prove the SNAP household willfully and intentionally committed an IPV or fraud: DTA failed to give written notice about reporting requirements in the household s own language as required under DTA s obligations to serve limited English proficient households; The household reported a change to the DTA office, but the DTA office failed to correctly record the change or process the documents; DTA relied on information from a data match that was not accurate; The head of household had a mental health impairment which prevented him or her from willfully and knowingly acting to defraud DTA. A statement from a health provider, such as a Food Stamp/SNAP Advocacy Guide 2017 February 2017 Page 205

6 psychologist, may be useful in showing that the individual did not act knowingly or willfully. 105 When can my benefits be stopped for an IPV or fraud? If you are found guilty of an IPV by a court of law or by a DTA hearing officer or you waived your right to an IPV hearing or signed a consent agreement in court you will not be eligible for SNAP benefits for yourself for one year for the first violation, two years for the second violation, and permanently for the third violation. 106 C.M.R (A). DTA has to follow special notice and hearing rules if it has charged you with an IPV. Be sure to check the rules. 106 C.M.R The disqualification period must start the month following the date that you received written notification of a hearing decision where the hearings officer made an IPV determination. 106 C.M.R If DTA misses that date, or starts the disqualification late, you should not be disqualified for additional months that DTA missed. Even if you are no longer getting SNAP at the point of the notification or during the disqualification, the SNAP disqualification period still starts the month following the month of the hearing decision. DTA cannot initiate a disqualification at some later date or suspend the disqualification until you reapply. Example: A hearings officer found that Rachel committed an IPV on July15, 2014 and disqualified her for 12 months. DTA then sent her a notice of the disqualification on July 17 th. Rachel was not getting SNAP at the time of the IPV disqualification. Her 12 months start August She can reapply in September of If Rachel has another family member, such as a child, she can still get SNAP for that child during the disqualification period, even though she is ineligible.

7 The disqualification penalties are more severe for people found guilty, in court, of trading SNAP benefits for drugs or firearms, trading more than $500 in benefits, or getting multiple benefits with a fake identity or address. 106 C.M.R (B), (C). Advocacy Reminders: ü An IPV is a very serious matter. Contact legal services right away if you get notice of an IPV. See Appendix E. ü DTA can stop SNAP benefits only for the person who committed the intentional program violation. The IPV disqualification does not affect children or other people who are in the same household with the person who committed the IPV. 106 C.M.R (F). ü If you received SNAP in another state and you were found to have committed an IPV in that state, DTA can continue that disqualification in Massachusetts. The length of the disqualification period starts with the date you were notified of the original IPV. Example: Philip was disqualified from SNAP in Montana on January 2017 for 1 year. His SNAP disqualification ends January 2018, even if moved to Massachusetts in March of Additional Guidance: Description of the electronic disqualified recipient system or edrs under USDA to track individuals under IPV SNAP sanctions in other states. Households have the right to dispute the e-drs finding and confirms an IPV disqualification does not affect other household members not disqualified (e.g. children). Ops Memo A, August 26, 2013 Individuals in SNAP households subject to an IPV or other sanction should receive notice from DTA of when the sanction period ends and be re-evaluated for benefits with the rest of the household. Transitions FYI (Sept. 2005). Food Stamp/SNAP Advocacy Guide 2017 February 2017 Page 207

8 106 What should I do if contacted by the Bureau of Special Investigations? If DTA thinks you were overpaid because of your mistake or because you committed fraud, it may refer your case to the Bureau of Special Investigations (BSI). 106 C.M.R DTA may also refer applications to BSI if the worker thinks you are lying about something. BSI may tell you to come in for an interview. You do not have to go to the interview. Your benefits won t stop just because you do not go to the interview. But if you don t go, BSI can decide to send the case back to DTA to collect the overpayment or BSI may decide to refer the case for a criminal prosecution of SNAP fraud. If you do go to a BSI interview, you have the right to remain silent. Anything you say can be used against you. It may be best to remain silent even if you have not done anything wrong. You do not have to give BSI names of people to talk to. Try to consult with an advocate before you meet with BSI or say anything. Do not sign anything unless BSI has shown you how it figured the overpayment, you are sure that all the calculations are correct, and you agree with everything in the statement you are signing. Do not agree to a repayment schedule that you will not be able to keep or that will cause your family hardship. If you are unsure, consult an advocate first. 107 Can I go to jail? Will I have a criminal record? If BSI decides that you committed SNAP fraud and that the overpayment was not just a mistake, you can be prosecuted. 106 C.M.R If you get notice of a criminal complaint, you should plead not guilty and ask the court to appoint a lawyer for you. Legal services programs do not represent people in criminal matters but they may help you and your lawyer figure out whether BSI has correctly computed what you owe.

9 If you plead guilty or you are found guilty, you will probably not have to go to jail, but the criminal record may make it harder for you to get a job, get credit, or get housing. A criminal record may also cause immigration problems. You may have to pay back the money the court decides you owe. Sometimes the court will delay a final decision as long as you pay back the money according to the schedule set by the court. This is called continued without a finding. Be careful not to agree to a repayment schedule you will not be able to keep. The federal SNAP rules permit you to ask the court to let you pay back the money through public service. 7 C.F.R (g)(7). If you pay the money back or pay the claim through public service, you may be able to get the case dismissed so you don t have a criminal record. If the court finds that you committed an IPV, your benefits can be stopped under the SNAP IPV sanction rules. See Question C.M.R , How does DTA collect an overpayment if I am getting SNAP? If you are getting SNAP, DTA can pay itself back by: not paying you for an underpayment you are owed. See Question 86. This is called offsetting. for unintentional overpayments, recouping 10% or $10 of your monthly SNAP, whichever is greater. 106 C.M.R (G) for intentional program violation overpayments, recouping 20% or $20 of your monthly SNAP, whichever is greater. 106 C.M.R (B)(2) Before reducing your benefits, DTA s Recoveries Unit will send you a letter telling you about the overpayment and asking you to the pay the claim. They may try to get you to sign a voluntary repayment agreement. You do not have to pay or sign an agreement to pay more than DTA could recover by automatically recouping some of your SNAP. You have the right to advance notice and an opportunity for a hearing before your benefits are reduced. 106 C.M.R , , Food Stamp/SNAP Advocacy Guide 2017 February 2017 Page 209

10 - Part 7 Overpayments and Fraud DTA may say you cannot challenge the overpayment at this point, so if you think the overpayment did not happen or the amount is not correct, you should request a hearing when you first get notice of the overpayment and should not wait to receive notice of the reduction before asking for a hearing. You have 90 days from date of the DTA action to request a fair hearing. See Question 94. A fair hearing request should stop collection of the overpayment until the hearing officer makes a decision. 7 C.F.R (e)(6). Contact an advocate if DTA tries to collect the overpayment while your hearing request is pending. DTA cannot take money for a SNAP overpayment out of your TAFDC or EAEDC. See M.G.L. c. 118, 10, 7 C.F.R (g)(1)(v). Advocacy Reminders: ü Check with an advocate if DTA uses any means other than reducing current benefits to collect an overpayment. Also check with an advocate if collection will cause your family hardship. Do not agree to repayment terms that you will not be able to meet or that will cause your family hardship. Additional Guidance: DTA can offset an underpayment (benefits owed to a household) by an established overpayment. Ops Memo (Nov 17, 2011). 109 How does DTA collect overpayments if I am not receiving benefits? DTA has several ways of collecting overpayments from former SNAP and cash recipients. But, if you file for a hearing because you do not agree with the amount of the overpayment, or disagree you were overpaid at all, DTA should suspend collection activities. 106 C.M.R (H) Voluntary repayment agreement If you are no longer receiving SNAP benefits, the DTA Recoveries Unit may ask you to sign a voluntary repayment agreement to pay a certain

11 amount of money each month, by sending them a regular payment. You do not have to agree to this. Credit Collection DTA can also turn over the debt to a collection agency, which may add an additional collection fee on top of what you owe. A collection agency is not permitted under state law to harass you, and cannot threaten to take the first $500 per week you earn in gross wages. And a collection agency can only take money from your bank account if you have more than $2,500 in the account, and they can only take the excess above $2,500. For additional protections, see G.L. c. 235, 34; 940 C.M.R. 7.07(18). Recovery from certain federal benefits If you do not agree to a voluntary repayment, DTA has the power to refer your claim to the U.S. Treasury. The U.S. Treasury can take money from your Social Security benefits (if you receive any) or from other federal benefits payable to you. If you are a federal government employee, they can collect from federal earnings you receive. See 7 C.F.R (n) and 106 C.M.R (E). They can also intercept a federal tax refund, see below. However, if you receive SSI, TAFDC, EAEDC, Veterans Services, or other needs-based cash benefits, these benefits cannot be reduced to repay SNAP overpayments. Federal rules say that DTA can intercept your unemployment compensation only if you agree or if a court orders interception. 7 C.F.R (g)(6). In addition, the SNAP rules say DTA can file a civil court action to intercept (take money) from your unemployment compensation, your wages, or use other reasonable means to collect an overpayment. 106 C.M.R A criminal court can order you to pay back the SNAP benefits you received if it finds you committed welfare fraud. Tax Offset Program (TOP) Under federal and state SNAP rules, DTA can use the Tax Offset Program and keep your federal tax refund if you owe the government money. 7 C.F.R (n) and 106 C.M.R (E) If you have a repayment plan with DTA, and you are making repayments, DTA should not intercept your tax refund. However, if you miss payments, DTA may intercept your tax refund or take additional action to collect money. Food Stamp/SNAP Advocacy Guide 2017 February 2017 Page 211

12 Advocacy Reminders: ü If you are a SNAP recipient, or very low income, and paying back the overpayment will cause you financial hardship, you can make a written request to DTA to ask they waiver or reduce the overpayment to an amount that you could pay over three years. If DTA refuses, you can also file an appeal and ask a hearings officer to consider your request to compromise the claim. This is an option only when the SNAP overpayment is caused by an unintentional error or agency error. ü See the MA Attorney General s Guide on Debt Collection, here: ü See resources on our MassLegalHelp webpage, I have debt. Help!