1142.000.00 SNAP Claims Determinations

1142.015.15 Intentional Program Violation

IM-14 February 2, 2022; IM-40 May 28, 2008; IM-142 December 2, 2005

An Intentional Program Violation (IPV) is a claim for an overpayment caused when a member(s) of the SNAP household intentionally makes a false or misleading statement, or misrepresents, conceals, or withholds facts, or engages in trafficking. Establish only those claims in which trafficking has occurred as IPV. On the Claim Add (OVTC) screen enter Program 11, Cause Code 91 for trafficking claims. For any other claim to be coded as IPV, the overpayment must be determined an IPV by way of an administrative disqualification hearing (ADH) or through a court hearing or waiver. Establish any claims in which it appears an IPV has occurred, but has not been proven, as an Inadvertent Household Error (IHE)/Suspected Program Violation (SPV), by entering Program 12, SPV code Y, and the appropriate cause code on the Claim Add (OVTC) screen. Document evidence of the SPV on the Note Add (OVNA) screen.

There is no threshold for referring and establishing IPV or SPV claims. SPV claims have a look-back period of thirty-six months, including the month of discovery. If any SPV overissuance month occurred within the 36-month look back period, the over-issuance may be calculated back for up to seventy-two months including the month of discovery. If there is no month in which an overpayment occurred within the 36-month look back period, a claim amount is not calculated.

The Welfare Investigation Unit (WIU) staff investigate the circumstances of SPV overpayments and obtains evidence, if available, to support the SPV. After obtaining evidence of the SPV, WIU staff must determine whether to refer the case to the prosecuting attorney or pursue an Administrative Disqualification Hearing (ADH). If the decision is to do an ADH, a Waiver of Administrative Hearing Disqualification Consent Agreement (IM-161) may be obtained. If a waiver of the ADH is not obtained, the WIU staff submits an electronic request for the ADH to the agency witness. The agency witness completes the Advance Notice of Your Administrative Disqualification Hearing (IM-160), and if indicated from the WIU referral the IM-161 and Withdrawal of Waiver of Administrative Hearing Disqualification Consent Agreement (IM-161A). Refer to SNAP Policy Manual Section 1145.010.20 Administrative Disqualification Hearing Scheduled. During the ADH the agency witness will present information obtained by WIU staff regarding the SPV or request the WIU staff attend the hearing. Refer to SNAP Policy Manual Section 1145.000.00 Disqualification for Program Violation for specific instructions.

If it is determined, by administrative disqualification hearing decision or court order, that an IPV occurred, WIU or Program Integrity Unit (PIU) staff will change the claim type from SPV to IPV by changing the program code from 12 to 11 on the CARS Change Claim Information (OVCC) screen. The disqualification is entered by the WIU staff or agency witness on the Sanction/Disqualification (FMAM) screen.