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749 Chapter 3:Processes and procedures • Section 5: Program integrity (07/2026) In all programs, both a non-citizen and the sponsor of the non-citizen are liable for an overpayment incurred if the overpayment results from the failure of the sponsor to provide correct information (see 461-145-0820 to 461-145-0840 and 414-175-0035). If the sponsor had good cause (see 461-195- 0521(5)) for withholding the information, the sponsor is not liable for the overpayment. Change in the payee/benefit group or program ODHS|OHA will continue to recover the overpayment from the benefit group in which the overpayment occurred, even if there is a change in the payee. If any member of the overpaid benefit group is eligible for and included in another group, recovery will be made from that group’s benefits, but only if the recovery is limited to the amount of overpayment incurred when the member actually resided in the household of, or was a member of, the overpaid benefit group. Provider overpayments Provider caused overpayments are calculated by an ODHS|OHA employee and reported to the Provider and Consumer Services Unit. These are provider payments received by adult foster care providers, community-based care providers, etc. The Provider and Consumer Services Unit will work out a reasonable repayment plan with the provider and a recoupment will occur (similar to a garnishment). HSD For the HSD medical programs, the following persons are liable for repayment of an overpayment: • Each individual who was in or was required to be in the HSD medical program household group except an individual who:
Was a child or dependent child at the time of the overpayment, or
Did not reside with and did not know they were included in the HSD medical program household group • A caretaker relative and their spouse who were not part of but resided with the HSD medical program household group when the overpayment was incurred • A parent or caretaker relative of a child in the HSD medical program household group and the spouse of the parent or caretaker relative if the parent, caretaker relative or spouse was a member of or resided with the HSD medical program household group when the overpayment was incurred • An authorized representative when the authorized representative knowingly gave incorrect or incomplete information or intentionally withheld information that resulted in the overpayment.