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Volume III | Chapter 14

14004 MISSISSIPPI [ CLAIMS: GENERAL ] Revised 12 - 01 - 17 07 - 01 - 19 payments in a larger amount than is proper when the applicant or recipient fails to provide accurate and complete information and there is no evidence that the client willfully misrepresented or withheld information. All indications are that the individual misunderstood or was unable to comprehend the relationship between information to be reported and eligibility requirements. Such cases include those in which the adult is senile, mentally ill or mentally challenged, or physically unable to communicate. The worker must be sure to document the client s explanation or why the client s statement is unavailable.

19 Suspected Intentional Program Violation (SIPV) A Suspected Intentional Program Violation occurs when the assistance unit intentionally falsified, misrepresented or withheld information that would have caused ineligibility or reduced benefits. The following guidelines should be used when determining if the claim is SIPV. 1. Whether the applicant or recipient obtained assistance by making a willfully false statement or knowingly withholding information affecting his eligibility. The worker must be alert to indications as to whether the individual understood that the information he gave or withheld had an effect on his eligibility. 2. Whether the applicant or recipient had given information on other factors of eligibility or at other times which appeared to contradict the later statements he made and whether it appeared that he made the later statements knowing that they were different. 3. Whether the county department relied on the individual s statement of his action, and granted or continued assistance to him on the basis of his statement. NOTE: These guidelines must be considered when determining if the claim should be worked as IHE or SIPV, since these are the two client error types of claims. If, after reviewing the client s statement or explanation for the failure to report a change etc., the worker is unsure if the claim is SIPV, the description of IHE should be reviewed before a determination is made of the claim type. Again, the worker must document the case and MISSISSIPPI

[CLAIMS: GENERAL] Revised 12-01-17 07-01-