4-007.01 Establishing Overpayments

475 NAC 4-007.01

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 overissuances 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;

4. The amount of the threshold for each type of household is applied at the time the overpayments are calculated.

There are three types of overpayments:

1. Administrative error: Any overpayment caused by the local office's action or failure to take action.

2. Inadvertent Household error: Any overpayment caused by a household's misunderstanding or unintended error.

3. Intentional program violation: Any overpayment that was caused by an intentional program violation by:

a. A disqualification hearing;

b. A court of appropriate jurisdiction; or

c. A household’s signing of a waiver of the individual’s right to a disqualification hearing.

{1/3/05}

4-007.01A Criteria for Establishing Administrative Error (AE) Overpayments

4-007.01B Criteria for Establishing Inadvertent Household Error (IHE) Overpayments

4-007.01C Intentional Program Violation

4-007.01D Criteria for Establishing Intentional Program Violation (IPV) Overpayments

4-007.01E Trafficked Benefits

4-007.01F Situations When Overpayments Are Not Established