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DEPARTMENT FOR AGING AND REHABILITATIVE SERVICES AUXILIARY GRANT PROGRAM ADMINISTRATIVE ISSUES 11/18 CHAPTER L PAGE 16

Code of Virginia, to collect the amount as debt, unless the administrative cost of such action would exceed the amount of overpayment.

• Fraud

 When an individual is found guilty of fraud, repayment if ordered will be by the terms of the court order. If found not guilty the methods specified in the “Overpayments other than Fraud” section above are applicable.

In the operation of any program of public assistance in any locality, for which program appropriations are made to the Department of Social Services, it is provided that if a payment or overpayment is made to an ineligible individual therefore under State statutes and regulations, the amount of such payment or overpayment shall be returned to the Department of Social Services by the locality.

However, no such repayments may be required of the locality if the Department determines that such overpayment or payments to an individual resulted from the promulgation of vague or conflicting regulations by DARS or from the failure of either or Central office to make timely distribution to the localities of the statutes, rules, regulations, and policy decisions causing the overpayment or payments to be made by the locality. Further no such repayment will be required from situations where a locality exercised due diligence, yet received incomplete or incorrect information which caused the overpayment or payments.

The criteria used for determining if a locality exercised due diligence are:

• a redetermination was not outstanding (overdue) in the case in question unless:

 the agency has received permission from the State to suspend reviews;  it can be shown that the error was the result of the individual willfully withholding information which would not have been discovered by verifications required at the time of the review; or  the error had not occurred at the time of scheduled review.

• the error was not the result of an anticipated change that was overlooked. • the error was not the result of the client reporting a change that the agency failed to follow up on. • the error was not the result of failure to use available management tools.