631 RECOUPMENT OF FINANCIAL ASSISTANCE (AAM)

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An overpayment is the amount of financial assistance that was incorrectly overpaid to or on behalf of a recipient. Financial assistance that is incorrectly paid on behalf of an individual is subject to recoupment if the erroneous payment was due to the client:

. withholding information;

. failing to comply with eligibility requirements; or

. making any type of error that results in incorrectly paid benefits.

This includes financial assistance paid to a recipient pending the outcome of an administrative appeal, if the individual loses the appeal. All overpayments must be repaid in full to the Division of Family Assistance (DFA) regardless of the length of time the overpayment has existed.

Before taking any recoupment action, refer any overpayments which involve recipients residing in:

. Residential care facilities to the Bureau of Elderly and Adult Services (BEAS); or

. Community residences to the Community Mental Health Agency if it is a mental health case, or to the Area Agency for Developmental Services if it is a developmentally disabled case, for investigation. The investigation will determine:

- situations which may require a review of the facility's certification;

- how recoupment may jeopardize placement;

- responsible party causing error;

- party responsible for recoupment; and

- whether a rate other than 10% of the standard of need should be negotiated.