SUBJECT:
TEMPORARY ASSISTANCE CLAIMS AUTOMATION
DISCUSSION:
The Temporary Assistance Program is in the process of automating the claims process. Once this process is completed, it will be similar to the current claims process utilized by the Food Stamp Program. Until the Temporary Assistance claims process is completely automated, steps need to be followed to ensure that the client has received proper notification of the claim and the impending recoupment.
Upon conversion to FAMIS, Temporary Assistance recoupment is no longer entered in IMU5, but is automated based on FAMIS interacting with information entered in the Claims Accounting and Restitution System (CARS).
Step 1- Send a notice of Adverse Action (IM80)
When the need for a claim is discovered on an active Temporary Assistance case, the claim is calculated and prepared for entry into CARS. Prior to entering the information into CARS, send an Adverse Action Notice outside of the FAMIS system. Inform the client that recoupment is being initiated and will continue until the claim has been paid in full. Note the total amount of the Temporary Assistance claim, the reason for the overpayment and the monthly recoupment amount (to be determined from Chapter X, Table 1).
When a claim is needed on a closed TA case, send an Adverse Action Notice outside of the FAMIS system. Inform the client of the total amount of the Temporary Assistance claim and the reason for the overpayment. In addition, inform the client that if s/he is approved for Temporary Assistance in the future, we will reduce the TA grant by the appropriate recoupment amount (determined by Chapter X, Table 1), based on case information at the time of closing, until the claim is paid in full.
If the client requests a hearing, within 10 days of the Notice of Adverse Action, do not enter the claim into CARS until the hearing decision is rendered. If the agency is affirmed, enter the claim into CARS and the automated recoupment process begins.
Step 2- IM80 expiration
When the Notice of Adverse Action expires, the claim is entered into CARS. See Chapter X, Section V for the entry process.
Step 3- Begin recoupment
FAMIS interfaces with CARS and recoupment is automatic based on the information entered. Once recoupment begins, FAMIS sends the client notice of the reduction of the Temporary Assistance benefit.
NOTE: It is important that the claim is entered after the Notice of Adverse Action has expired. Once a claim is entered into CARS, FAMIS immediately begins recoupment.
Recoupment due to a notice of an active claim in CARS: If an adverse action was not sent prior to the claim being entered into CARS, an adverse action must be sent. When the Adverse Action Notice expires, there is nothing more for the worker to do as FAMIS will interface with CARS automatically and begin the recoupment based on that information.
AUTOMATED RECOUPMENT
CARS automatically initiates recoupment on any claim that is eligible to be paid through the reduction of Temporary Assistance benefits.
All Temporary Assistance claim recoupments are based on Chapter X Table 1. See Table 1 below taken from Chapter X, Section V, page 14.
Assistance Group |
Amount of Reduction up to * |
1 |
$12 |
2 |
$21 |
3 |
$27 |
4 |
$32 |
5 |
$36 |
6 |
$40 |
7 |
$44 |
8 |
$48 |
9 |
$52 |
10 |
$55 |
11 or more |
add $4 for each additional person |
*NOTE: The amount of the reduction cannot exceed the amount of the Temporary Assistance grant. For grants less than the amount of reduction, the recoupment is the amount of the grant for which the claimant is eligible to receive less $1.00, until the entire amount is recouped.
The conversion controlled flow must be processed before FAMIS can begin recoupment. It is important that all recoupment cases get taken through the flow as soon as possible after conversion to ensure that the recoupment process remains uninterrupted.
Note: The recoupment amount will not be seen on PAYHIST until after the payroll closing date.
NECESSARY ACTION:
- Review this memorandum with appropriate staff.
- Do not enter a Temporary Assistance claim into CARS until the adverse action notice has expired.
- Allow for fair hearing requests as appropriate.