218 R.I. Code R. 218-RICR-20-00-1.17 - [Effective 4/29/2025] 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.
1.17.1
Collection 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.
1.17.2
Delinquent
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.
1.17.3
Compromising 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.
1.17.4
Terminating 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.
1.17.5
Offsetting 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.
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