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Page 144 Iowa Department of Health and Human Services Employees’ Manual Overpayment Recovery Title 13: Social Service Resources Chapter G: Child Care Assistance June 14, 2024 Failure to Cooperate If the overpayment involves suspected collusion between the provider and client to create a fraudulent payment, follow the procedures for recoupment for both the client and provider. When completing your summary on the Fraud Referral screen in the OPR system, be sure to supply information on the suspected collusion and the relevant client information. Comment: The ABC Center begins caring for Mr. K’s daughter on July 15. The center bills the Department for two units per day, five days per week. On September 10, Mr. K’s daughter starts kindergarten. The center continues to report attendance to the Department showing the need for two units per day per week, although the child attends the center only after school. During a case review on November 15, the worker finds the error and contacts Mr. K to verify that his daughter is attending school. Mr. K affirms that his daughter is at school during the day. The worker issues a timely notice of decision to the client and the provider with the corrected authorization of units. The worker informs the center that she is investigating a possible overpayment and needs the records for verification. After ten days, the worker hasn’t received the information from the center. The worker refers the case to DIAL. The amount of the overpayment is calculated as follows: 1 unit per day x 45 days (September 10-November 15). Notifying DIAL of the Overpayment Legal reference: 441 IAC 170.9(1) Policy: Refer all Child Care Assistance (CCA) overpayments to the Department of Inspections, Appeals, and Licensure (DIAL) Procedure: When you have determined a CCA overpayment occurred, documented it in the case record and make entries into the Overpayment Recovery System (OPR). The OPR system automatically determines whether the worker needs to complete a fraud referral to be submitted along with the overpayment claim. NOTE: When a provider returns the original CCA warrant, you do not need to refer the overpayment to DIAL if the warrant covers the total amount of the overpayment and the period of overpayment is only one month. (This does not apply to refunds by money order, personal check, or cash.)