Food Stamps

1142.015.15 Intentional Program Violation

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 Food Stamp EU 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 IHE/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.

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 ADH. The investigator discusses the evidence with the County Manager, and they make a joint decision to pursue an ADH or not. 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, a referral is made to the county FSD office to do the ADH hearing. Once the decision is made to pursue an administrative disqualification, the WIU investigator works with the county staff to ensure that the ADH will be held. Submit a hearing request and complete the hearing in the same manner as for other hearings. Present information obtained by WIU staff regarding the SPV or request the WIU investigator appear at the hearing. Refer to Food Stamp Policy Manual Section 1145.000.00 DISQUALIFICATION FOR PROGRAM VIOLATION, for specific instructions.

If WIU staff returns the SPV to the county office without obtaining information to prove the SPV and county staff has information that substantiates the IPV, initiate an ADH hearing as outlined in Food Stamp Policy Manual 1145.030.00 USE OF ADMINISTRATIVE DISQUALIFICATION HEARINGS.

If it is determined by administrative disqualification hearing decision, or court order that an IPV occurred, 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 Hearings Unit on the Sanction/Disqualification (FMAM) screen.

If it is determined by WIU that the overpayment is not an intentional program violation, the WIU agent updates the WIU code to 70-78, changes the SPV indicator to N, and returns the case to the county. If WIU returns the case to the county without changing the SPV indicator to N, the worker should change the indicator.