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Referrals to the Special Investigations Unit (SIU)
(ACL 23-92 SIU section revised based on this letter)
To maintain and improve program integrity for cash aid and CalFresh benefits, suspected fraud and other crimes must be reported to the Special Investigations Unit (SIU) (MPP Section 20-003 and MPP 20-004).
SIU Referral Criteria
A referral for investigation must be made when:
- There is a public allegation/report of fraud, and/or
- The EW's observation of conditions which based on the EW's knowledge of the case provides reason to suspect that fraud exists or has been attempted by the client (MPP section 20-003.1).
A potential reason to suspect fraud would be that the alleged theft withdrawal was not consistent with any of the Typical Scamming Processes.
SIU Investigation
The repayment/replacement of electronic theft claims must not be delayed unless the referral is made due to the EW's suspicion of fraud.
If the SIU investigation results determine the claim is fraudulent and the electronic theft repayment/replacement has been issued, SIU must pursue appropriate prosecutorial or administrative actions, pursuant to Title 7 CFR Section 273.16(a).
Overpayments/Overissuances
If the amount of the electronic theft is determined to be an overpayment/overissuance (OP/OI), the worker must: establish an OP/OI, issue an NOA, and begin collection of the ineligible amount following district office procedures. This OP/OI must be treated as an administrative error OP/OI. Refer to Overissuance and/or Overpayment Repayments.
Security Breaches
The CDSS is authorized to issue mass reimbursements to recipients for the loss of cash benefits if the department finds the benefits of multiple recipients were taken by an unauthorized withdrawal, removal, or use of benefits in which the recipients’ electronic benefits transfer card numbers or PINs were obtained through a data breach. In these isolated situations, the CDSS will immediately contact the county and consortia staff and provide further instructions. Affected recipients will be notified that their benefits have been restored.
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