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4.5 Improper Payments
A. Overpayment Due to Fraud
Anyone who causes the LDSS to make an improper provider payment by withholding required information or by providing false information will be required to repay the amount of the improper payment.
B. Non-Fraud Overpayment
In cases of non-fraud overpayment, the parent may continue to participate in the subsidy program as long as a repayment schedule is entered into with the LDSS and payments are made according to that schedule. All overpayments must be repaid to the state by the locality according to the procedures outlined in subsections F and G.
C. Overpayment Due to Local Department Error
If an overpayment related to eligibility for services or related to copayment amount was made as a result of an error by the LDSS, the LDSS will not seek to recoup those funds from the parent or the provider. All overpayments must be repaid to the state by the locality.
D. Overpayment Begin Date
The overpayment begins the month following the month the change occurred. The LDSS will determine the overpayment begin date and secure all verifications necessary to calculate the overpayment. Provider payments issued and payment reductions delayed as a result of the advance notice period are not overpayments.
E. Outstanding Overpayments
Outstanding overpayments must be recovered prior to a former recipient being found eligible. The repayment schedule is to be based on the current situation of the individual. The allowable amount of recovery of the overpayment from the individual is limited to the total amount of the overpayments. When Child Care services are overpaid, only the adult(s) included in the family unit at the time the overpayment occurred will be responsible for repayment of the overpayment.
F. Repayment Agreement and Schedule
VaCMS provides a tracking system to ensure that repayments are established and satisfied. Recipients may be required to enter into a repayment agreement for failure to pay required fees; failure to make satisfactory arrangements to pay back fees owed; discontinuation of employment or other approved or assigned activity; failure to report changes to non-financial or financial eligibility requirements; failure to make satisfactory progress in education/training; failure to provide necessary verifications/information; or failure to report changes specified on the Child Care Application and Notice of Action form.