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______________________________________________________________________ DIVISION OF WELFARE AND SUPPORTIVE SERVICES Child Care Policy Manual I&R will pursue collection of non-active Provider overpayments when referred by the Contractors. All overpayments for active childcare providers must be pursued by the Contracted agency in accordance with their contract with the DWSS. Active Provider overpayments are recouped through future provider payments. 771 Right to Appeal The responsible individual may appeal the amount and/or how the claim was determined within 90 calendar days from the date of the claim notification. The request must be in writing and forwarded to the Child Care Program Office. All recovery actions are suspended during the appeal/hearing process until a decision is rendered. If the hearing office determines the claim does in fact exist, responsible person(s) must be re-notified of the claim. Note: Refer to manual section 550 through 563 for further details on the appeal/ hearing process. 780 CALCULATING A CLAIM Claims are calculated whenever documentary evidence substantiates the Child Care and Development Program incorrectly paid benefits to any individual or group of individuals. Claim classifications (Customer, Provider, Welfare or Contractor errors) play no part in determining whether a claim is or is not calculated. 781 Request Claim Calculation Any authorized Child Care and Development Program staff member may request a claim calculation be made by completing section one of the Child Care Overpayment Referral form 2154 –WC A or B and forwarding the original to designated contractor personnel for follow-up. A copy of the form must be kept in the eligibility case file. 782 Determining if an Claim Exists To determine whether a claim exists, the child care contractor must obtain written verification of the questionable issue. Contractor staff may pursue evidence necessary to proceed with the claim calculation; however, it cannot be requested at the same time information to determine initial and continuing eligibility is being requested. If the information/verification to determine past eligibility/benefits is not provided, it cannot cause a denial/termination for failure to cooperate. If reasonable attempts made to secure documentary evidence prove unsuccessful, the Contractor may, with written approval from the Child Care and Development Program Chief, terminate calculation efforts. 783 Calculation of the Claim Amount All claims must be calculated by the child care contractor within 60 calendar days of receipt of all necessary collateral information. Prior to initiating the calculation process, the Contractor must ensure they possess credible evidence, which clearly substantiates, verifies or confirms the customer received benefits they were not entitled to for a specific period of time. 700- Program Violations, Overpayments, Hearings [13] MTL 01/24 July 1, 2024