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724 Chapter 3:Processes and procedures • Section 5: Program integrity (07/2026) for shelter, utilities, household supplies (other than food, and personal incidentals the individual could not meet with other immediately available resources). Payment amounts are limited to 200 percent of the payment standard for the benefit group. • A misappropriated payment is when a person cashes and retains the proceeds of a check from ODHS|OHA on which that person is not the payee, and the check has not been lawfully endorsed or assigned to the person. • A benefit or service is provided for a need when that person is compensated by another source for the same need and the person fails to reimburse ODHS|OHA when required by law. • A cash benefit received by an individual in the General Assistance (GA) or SFPSS programs for each month for which the individual receives a retroactive Supplemental Security Income (SSI) lump-sum payment; Effective April 21,2021 for Medical Assistance the Department: • Shall not establish an administrative error overpayment • Shall not establish a client error overpayment unless an individual received unreduced liability or unreduced benefits pending a contested case hearing decision or other final order favorable to the Department • May establish a fraud overpayment when a court determines the individual made a false or misleading statement or misrepresented, concealed, or withheld a fact for the purpose of establishing or maintaining eligibility ODHS|OHA provides overpayment identification and collection services to the extent possible based on the following expectations: • ODHS|OHA has a responsibility to ensure that state and federal funds are appropriately expended and to identify where funds have been misapplied. • Individuals receiving services or payments have a responsibility to provide timely and accurate information to assist ODHS|OHA in appropriate distribution of services and funds. • ODHS|OHA will hold claimants accountable for repayment of overpayments. • When overpayment recovery is necessary, the process must be clear and fair to all parties to maintain public trust. Other resources Overpayment Referral Submission *includes screenshots: This QRG discussed the Benefit Recovery functionality and provides steps to submit an overpayment referral and review the Potential Discrepancy Referral screen. Identifying potential overpayments Identifying who is responsible for the overpayment is an important part of the process. Overpayment situations are often complicated. E.g., payment for a service goes to a provider while the participant receives benefits from the service. The overpayment process provides the basis for determining: • When an overpayment occurs • Who is responsible for the overpayment error • The type of overpayment (overpayment categories)