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BAM 720 5 of 19 INTENTIONAL PROGRAM VIOLATION BPB 2026-009 4-1-2026

BRIDGES ADMINISTRATIVE MANUAL STATE OF MICHIGAN DEPARTMENT OF HEALTH & HUMAN SERVICES

OIG REFERRAL CRITERIA All Programs Prudent judgment should be used in evaluating an overpayment for suspected IPV. Consider the following questions when reviewing the case: • Does the record show that department staff advised the client of their rights and responsibilities? • Does the record show the client’s acknowledgment of these rights and responsibilities? • Did the client neglect to report timely when required to do so? • Did the client appear to make false or misleading statements? • Does the client error meet suspected IPV criteria? • Does the amount meet the OIG dollar threshold found below?

Suspected IPVs are referred to OIG when: • From preliminary review, it appears that the overpayment falls within the definition of suspected IPV, and • The total overpayment amount for all programs combined is $500 or more, or • The total overpayment amount for all programs combined is less than $500, and The group has a previous IPV, or Misuse or trafficking are suspected, or It involves concurrent receipt of assistance; see Bridges Eligibility Manual (BEM) 222, or The client has had at least two client errors previously, or The alleged fraud is committed by a state government employee.

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Page 5

Official source

BAM 720 5 of 19 INTENTIONAL PROGRAM VIOLATION BPB 2026-009 4-1-2026

BRIDGES ADMINISTRATIVE MANUAL STATE OF MICHIGAN DEPARTMENT OF HEALTH & HUMAN SERVICES

OIG REFERRAL CRITERIA All Programs Prudent judgment should be used in evaluating an overpayment for suspected IPV. Consider the following questions when reviewing the case: • Does the record show that department staff advised the client of their rights and responsibilities? • Does the record show the client’s acknowledgment of these rights and responsibilities? • Did the client neglect to report timely when required to do so? • Did the client appear to make false or misleading statements? • Does the client error meet suspected IPV criteria? • Does the amount meet the OIG dollar threshold found below?

Suspected IPVs are referred to OIG when: • From preliminary review, it appears that the overpayment falls within the definition of suspected IPV, and • The total overpayment amount for all programs combined is $500 or more, or • The total overpayment amount for all programs combined is less than $500, and The group has a previous IPV, or Misuse or trafficking are suspected, or It involves concurrent receipt of assistance; see Bridges Eligibility Manual (BEM) 222, or The client has had at least two client errors previously, or The alleged fraud is committed by a state government employee.