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MS 0910 (1) Volume 1 – General Administration MS 0910 – R. 11/1/25 – OMTL-685 Referral of Claims to the Office of Inspector General The Department for Community Based Services (DCBS) contracts with the Office of Inspector General (OIG) of the Cabinet for Health and Family Services (CHFS) to investigate and pursue prosecution of individuals suspected of fraudulently receiving or trafficking program benefits. A. The following claims are referred to OIG for investigation: 1. Medicaid (MA) claims, regardless of the amount, when an individual has withheld or provided false information to receive assistance. MA claims are not entered on the Integrated Eligibility and Enrollment System (IEES) unless adjudicated through the court system. 2. [A Kentucky Transitional Assistance Program (KTAP), Kentucky Works Program (KWP) supportive services, Kinship Care (KC), Family Assistance Short Term (FAST), Work Incentive Reimbursement (WIN), Relocation Assistance Program (RAP), or Supplemental Nutrition Assistance Program (SNAP) case suspected of fraud, when the claim amount: a. Is estimated to be $10,000 or more due to unreported wages only; b. Is estimated to be $3,000 or more for reasons other than unreported income; c. There is a companion case(s), and the combined amount is estimated to be $3,000 or more; or d. There is a companion MA case with at least one month of suspected ineligibility. 3. SNAP trafficking cases/referrals that are believed to be $10,000 or more. 4. SNAP trafficking involving controlled substances, firearms, ammunition, or explosives, regardless of the suspected amount. Note: Any trafficking that does not meet the criteria of items 3 or 4 will need to be handled administratively. 5. Child Care Assistance Program (CCAP) recipient eligibility claims estimated to have a value of $5,000 or more AND suspected to be fraudulent. 6. Child Care provider claims of $10,000 or more and evidence of fraudulent billings, limited to the availability of funds. 7. Low-Income Home Energy Assistance Program (LIHEAP) cases, regardless of the amount.]