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An improper UPP payment occurs when an enrollee receives an UPP reimbursement payment for which he is not eligible. An individual is responsible to repay the Department for the amount of any incorrect UPP payment issued.

Submit or send an overpayment referral to the DWS overpayment unit for an UPP overpayment caused by Suspected Intentional Program Violation, Agency error, and insurance coverage cost changes, health insurance plan changes, or the health insurance policy terminates.

Agency and Inadvertent Errors

When improper UPP coverage occurs due to an agency or an inadvertent error, correct the error and send the proper notice. Submit an overpayment. If the overpayment was the result of a timely report, no collection will be required.

Suspected Intentional Program Violation (SIPV) Errors

When improper UPP coverage occurs because of a SIPV error or untimely reporting on the part of the enrollee, submit an overpayment. Collection will be required. See Section 1009-1 .