Page 7

6 · AG failure to provide correct or complete information · AG failure to report required changes in the AG's circumstances · AG receipt of benefits (or more benefits than it was entitled to receive) pending a fair hearing decision. 4610.15.00 SUSPECTED FRAUD DEFINITION Fraud is the act whereby a person willfully and deliberately makes false statements or suppresses facts or gives information which misrepresents the true circumstances regarding themselves or others for the purpose of receiving assistance to which there is not entitlement. Suspected fraud over issuances can occur because of the AG: · Misrepresenting information · Concealing information · Withholding information pertinent to determining eligibility, including untimely reporting · Failing to report a change to continue to receive benefits for which the AG was not entitled · Intentionally altering or changing documents to obtain benefits to which the AG was not entitled. Fraud, in all its aspects, is a matter of legal determination. Therefore, fraud does not exist until this legal determination has been made through the criminal court. Once the suspected fraud claim has been calculated but not yet opened, the entire claim case will be submitted to the Bureau of Investigations for review and approval. 4610.15.10 DETERRENTS AGAINST FRAUDULENT ACTIVITY The DFR is to establish deterrents against fraudulent activity through: · Skilled investigation · Careful explanation of all eligibility requirements to applicants/recipients · Diligent use of collaterals and other sources of information · Verification of facts · Alertness to possible misunderstandings · Follow-up investigations were indicated · Establishment of procedures for handling cases of suspected fraud to ensure thorough investigation and proper referrals to the County Prosecutor. · Cooperation with the news media in publicizing cases prosecuted for welfare fraud.