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BAM 720 6 of 19 INTENTIONAL PROGRAM VIOLATION BPB 2026-009 4-1-2026

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

CDC Provider Error Only Refer overpayments of $500 or more caused by a provider’s intentional false billings or intentional inaccurate statements. Some examples are: • Failing to bill correctly. • Receiving CDC payment for care paid by a third party. • Receiving CDC payment for hours when the child was not in care and the absence was not allowable; see BEM 706. State Emergency Relief (SER) Only Suspected IPVs can be combined with FIP, SDA, RCA, FAP and CDC programs to meet the OIG referral threshold of $500. FIS/ES must calculate the overpayment amount and period before sending a referral to OIG FAP MISUSE Overpayment claims arising from misuse or trafficking of benefits will be the value of the benefits as determined by: • The individual's admission, or • Adjudication, or • The documentation that forms the basis for the determination. Such as: Sworn testimony from a federal or state investigator, or An affidavit from a store owner of how much an individual could have reasonably misused or trafficked. This can be established through circumstantial evidence.

OIG RESPONSIBILITIES All Programs Suspected IPV cases are investigated by OIG. OIG will: • Refer suspected IPV cases that meet criteria for prosecution to the Prosecuting Attorney.

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Official source

BAM 720 6 of 19 INTENTIONAL PROGRAM VIOLATION BPB 2026-009 4-1-2026

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

CDC Provider Error Only Refer overpayments of $500 or more caused by a provider’s intentional false billings or intentional inaccurate statements. Some examples are: • Failing to bill correctly. • Receiving CDC payment for care paid by a third party. • Receiving CDC payment for hours when the child was not in care and the absence was not allowable; see BEM 706. State Emergency Relief (SER) Only Suspected IPVs can be combined with FIP, SDA, RCA, FAP and CDC programs to meet the OIG referral threshold of $500. FIS/ES must calculate the overpayment amount and period before sending a referral to OIG FAP MISUSE Overpayment claims arising from misuse or trafficking of benefits will be the value of the benefits as determined by: • The individual's admission, or • Adjudication, or • The documentation that forms the basis for the determination. Such as: Sworn testimony from a federal or state investigator, or An affidavit from a store owner of how much an individual could have reasonably misused or trafficked. This can be established through circumstantial evidence.

OIG RESPONSIBILITIES All Programs Suspected IPV cases are investigated by OIG. OIG will: • Refer suspected IPV cases that meet criteria for prosecution to the Prosecuting Attorney.