Overpayment for maintenance or special expenses (includes any service under contract or with prior authorization) may occur for any number of reasons. Recoupment must occur and must be made using this procedure:
- Reasons overpayment may occur:
- Adoptive parent(s)/guardian(s) have not properly notified the Division of changes in their or the eligible child’s circumstances;
- Child is no longer eligible because of age or is no longer the legal responsibility of the adoptive parent(s)/guardian(s);
- Adoptive parent(s)/guardian(s) have received payment for services authorized in the Agreement (includes the attachment), which have not been obtained;
- Adoptive parent(s)/guardian(s) received payment for services which did not have prior authorization; i.e., services were not authorized in Adoption Subsidy Agreement, CD AD, or Subsidized Guardianship Agreement, CD SG;
- A contracted provider received payment for services not delivered or before or after the dates specified in the Adoption Subsidy or Subsidized Guardianship Agreement. If payment was made directly to a contracted provider, repayment will be secured from that provider. Use the debiting procedure described in Section 4 Chapter 11 Attachment E Overpayment of Maintenance. Contact the Payment Unit in Central Office to initiate the debiting procedure.
- Procedure for repayment from adoptive parent(s)/guardian(s):
- Notify the adoptive parent(s)/guardian(s), in writing, that an overpayment has been made. Include, in the notification, the amount of the overpayment, the time period of the overpayment, and the service(s) for which overpayment has been made. Also, include a request that the adoptive parent(s)/guardian(s) contact the worker to discuss the matter to arrive at a plan for repaying the Division for any overpayments.
- Arrange a repayment plan with the adoptive parent(s)/guardian(s); obtain supervisory approval; and confirm the repayment plan in writing.
- Repayment process:
- Contact the Payment Unit in Central Office to initiate this debiting process;
- If it appears that the adoptive parent(s)/guardian(s) will continue to receive payment for some type of service, use the debiting process described in Section 4 Chapter 11 Overpayment of Maintenance; or
- If the adoptive parent(s)/guardian(s) will no longer receive a payment, they are to pay the agreed upon amount via check or money order, addressing it to “Missouri Children’s Division”. The adoptive parent(s)/guardian(s) give the check or money order to their worker. The worker is to print out the ZPAY screen, highlight the amount of the overpayment, and send the check or money order and the ZPAY printout to the Payment Unit in Central Office. The Payment Unit will then, send the payment to Budget and Finance.
- Procedure for repayment from a contracted provider:
- Notify contracted provider of overpayment using the CS-65, Children’s Services Integrated Payment System Invoice Instructions; and
- Initiate contact with the Payment Unit to debit the contracted provider.
- Procedure for repayment from a non-contracted provider.
Since payment to the provider was initially the responsibility of the adoptive parent(s)/guardian(s), repayment will be secured from the adoptive parent(s)/guardian(s). Use the procedures under “B” for obtaining repayment. Providers, who indicate to the Division that they have not been paid, when Division records indicate payment for a service has been made, should be directed to the adoptive parent(s)/guardian(s). The worker should also make immediate referral to the Welfare Investigation Unit (WIU) to initiate action for repayment.
- Procedure for any refusal to repay. If the adoptive parent(s)/guardian(s) refuse to make repayment, the following steps must be taken:
- Confirm refusal in writing;
- Inform the Circuit Manager/Program Manager of refusal and the amount due as repayment to the Division;
- The Circuit Manager/Program Manager shall write to the adoptive parent(s)/guardian(s) identifying the repayment due the Division and request payment within 30 days from the date of the letter; and
- If payment is not received within 30 days, refer to Welfare Fraud Unit via the Referral for Investigation, DOI-1 with notification to the Regional Director that such action has occurred.
- Referral to the Welfare Fraud Unit:
- Send DOI-1 to the appropriate Welfare Fraud Unit located in one of their five Family Support Division regional offices; and
- Cooperate with the Welfare Fraud Unit and update record in a timely manner.
Once the DOI-1 is sent, the matter of reimbursement to the Division is a Welfare Fraud Unit issue. Children’s Division staff shall not accept payments from adoptive parent(s)/guardian(s) or other providers at this time as the Welfare Fraud Unit’s case will be jeopardized.
When the Welfare Fraud Unit contracts with the adoptive parent(s)/guardian(s) or other providers for restitution payments, the adoptive parent(s)/guardian(s) is eligible for subsequent adoption subsidy payments only if restitution payments are being made or have been made.
The Welfare Fraud Unit will send a Disposition of Fraud Referral form, DOI-6 to the referring county/circuit to establish the status of the case. Contact may be made with the Welfare Fraud Unit for information regarding repayment.