Supplemental Nutrition Assistance Program (SNAP) Manual – Table of Contents

1142.020.00 CLAIMS REFERRAL PROCEDURES AND DETERMINATION OF DATE OF DISCOVERY

IM-50, May 15, 2020, IM-#142 December 2, 2005

CARS is divided into two areas, the discovery tracking system and the claim tracking system. A discovery claim referral is tracked from date of discovery through notification to the EU that an overpayment has occurred by generation of a demand letter or rejection of the referral. Once a claim is established, the claim tracking system is used to monitor collection activity.

A Program Integrity Unit staff member registers a discovery claim referral in CARS using the Discovery Add (OVAD) screen to begin the discovery tracking process when a potential overpayment exceeds the threshold or is a result of a quality control review or suspected fraud is identified. Enter the date the potential claim is verified as the date of discovery. A discovery identifier is assigned, which includes the 10-digit DCN, the date of the discovery, and a sequence number to track the number of food stamp claims discovered for the DCN on that day.

CARS uses the date of discovery to determine that the claim was established in an appropriate time frame. When a claim referral is registered, CARS calculates the due date of the claim. The discovery claim referral must be acted on and the claim established or rejected by the last day of the quarter following the quarter in which the potential claim was discovered. A Weekly Pending Discovery Claim Referral Report (FCLWK500-01) shows three days prior to the end of the quarter as the due date to act on the claim referral for management purposes.

Claim referral procedures vary according to how the potential claim is discovered:

An Eligibility Specialist discovers potential overpayment that exceeds the threshold or that appears to be fraud:

  • The Eligibility Specialist sends claim referral and PIU staff registers the discovery claim referral in CARS on the Discovery Add (OVAD) screen.
  • The date of discovery is the date the PIU staff obtains the verification that is used to calculate the over-issuance.

Potential overpayment is discovered as a result of quality control review:

  • The quality control supervisor or analyst registers the discovery claim referral in CARS.
  • The date of discovery is the date the supervisor signs off on quality control review findings.

The Welfare Investigation Unit (WIU) establishes trafficking of food stamp benefits:

  • WIU notifies the PIU case analyst that trafficking occurred, the amount of the claim, and the period of the claim.
  • The PIU staff registers the discovery claim referral in CARS.
  • The date of discovery is the date the PIU case analyst receives notice of trafficking from WIU.

WIU, Food Stamp Program and Policy Unit, or another source discovers a potential overpayment:

  • The PIU staff are notified of the possible overpayment and register the discovery claim referral in CARS.
  • The date of discovery is the date the PIU case analyst obtains the verification used to calculate the overpayment.