Overpayment Claims and Redeterminations

Overpayment Claims

Overpayment claims must be transferred to the receiving county with supporting documentation. Minimal overpayment claim information is included in the SDT. Information is sent for overpayments that are in an open/active status at the time of the eICT sending transaction and include:

Program Type,
Error Type (i.e., AE, IHE, or IPV), and
Number of errors occurred (the number of overpayments per program per error type).

Supporting Documentation

Supporting overpayment documentation for the current active claims must be sent to the receiving county within the 7-day time frame. Supporting overpayment documentation for each additional open claim must be sent within 90 calendar days of the date the eICT is initiated.

The eICT comment section must include:

Program Type,
Claim Type,
Last recoupment amount, and
Balance remaining for each overpayment.

Annual Redeterminations

[40-187]

If the recipient moves out of the county during either of the last two months of the certification period, the receiving county will complete the RD/RC. The sending county may complete the RD/RC if both the sending county and receiving county mutually agree it is in the recipient’s best interest to do so.

SAR 7

When a recipient moves out of the county during either of the last two months of the semi-annual period, the receiving county is responsible for obtaining a complete SAR 7. The sending county may process the SAR 7 if both the sending county and receiving county mutually agree it is in the recipient’s best interests to do so.

Overpayment Claims and Redeterminations