Page 52

10-148 Chapter 6 page 52

c. Inaccurate reporting of household circumstances; d. Accepting duplicate payments or any payments issued in error; e. Inaccurate reporting of actual charges or a Child’s attendance; and/or f. Any other false claim for Child Care Services provided. 4. The Overpayment shall be considered as both Parent and Child Care Provider caused if the Parent and the Child Care Provider both participated in the action that caused the Overpayment to occur. 5. The Department shall make a preliminary determination of whether the Overpayment was caused by a Misrepresentation based on the information and evidence and pursuant to these rules. Overpayments shall be considered and pursued if the Parent or Child Care Provider withheld or provided false information on matters affecting eligibility, benefits, or a claim for services. 6. Where the Department makes a preliminary determination that a Parent or Child Care Provider may have committed a Misrepresentation, the case may be referred to the DHHS Fraud Investigation Unit pursuant to 22 M.R.S. § 13 and the Department may pursue establishment of a Misrepresentation against the Parent and/or Child Care Provider administratively. 7. A final determination that a Misrepresentation occurred shall be made only as the result of a decision by an Administrative Hearing, a court, or waiver of the Administrative Hearing by the Parent and/or Child Care Provider. Failure to request an Administrative Hearing constitutes a waiver. E. Calculating the Improper Payment 1. Improper Child Care Affordability Program payments shall be calculated by comparing the Child Care Affordability Program payment during the applicable benefit weekly to the Child Care Affordability Program payment that would have been payable if eligibility and Child Care Affordability Program payment had been calculated correctly. The difference between the correct Child Care Affordability Program payment and the amount of the Child Care Affordability Program payment paid shall be the amount of the weekly improper Child Care Affordability Program payment. 2. The calculation is applied on a month-to-month basis for the improper payment period. The aggregate sum of the monthly improper Child Care Affordability Program payments within the improper Child Care Affordability Program payment period is the net amount of the improper Child Care Affordability Program payment or the Overpayment/Underpayment amount.