Step one: Determine who benefited from the overpayment

Family overpayments

If CCAP paid for more care than the family was eligible to receive, the family benefited. Assign the overpayment to the family except in the situations identified below as provider overpayments.

Examples of when overpayments may be assigned to the family include when:

· A parent commits an Intentional Program Violation (IPV) and has been disqualified for fraud. See Chapter 13.6 (Disqualification for Wrongfully Obtaining Assistance – Families).

· More hours of care were authorized and paid by CCAP than what the family was eligible for because of a family’s actions or errors or a combination of agency error and the family’s actions or errors. See Chapter 9.1 (Authorizing Child Care) and Chapter 9.9 (Determination of Payment Amounts).

· A family’s income exceeded 85% SMI during the 12-month eligibility period, and it was not reported. The family was ineligible for CCAP for part of their 12-month eligibility period. See Chapter 8.3 (Reporting Requirements).

· A family fails to report at application or redetermination.

· A family fails to report during the 12-month eligibility period.

Provider overpayments

When the family did not benefit from an overpayment, but the provider received more child care assistance than was correct, assign the overpayment to the provider.

Examples of when overpayments may be assigned to the provider include when:

· A provider commits an Intentional Program Violation (IPV) and has been disqualified for fraud. See Chapter 13.9 (Disqualification for Wrongfully Obtaining Assistance – Providers).

· The rates paid by CCAP are higher than what CCAP policy allows because of a provider’s actions or errors or a combination of agency error and the provider’s actions or errors. See Chapter 9.24 (Provider Rates).

· A provider does not indicate an absent day or holiday on the billing form when a child did not attend care, regardless of whether the child reached or is exempt from the absent day or holiday limits for the year. See Chapter 9.15.9 (Care During Child Absences) and Chapter 14.6 (Amount of Overpayment).

· A provider fails to comply with attendance record keeping requirements. See Chapter 11.15 (Provider Record Keeping) and Chapter 14.6 (Amount of Overpayment).

· A provider submits and is paid for hours that a child was not scheduled and authorized for in the Daily Scheduled Attendance Record portion of the billing form, such as including hours that a child was in school and not scheduled to be in the provider’s care. See 9.1 (Authorizing Child Care), care cannot be authorized and paid during hours a child is in school.

· A legal nonlicensed provider cares for children from more than one unrelated family at the same time. See Chapter 11.9 (Legal Nonlicensed (LNL) Providers).

· A legal nonlicensed provider cares for more total children than allowed or for children outside of the allowed age category limits at any one time. See Chapter 9.1.18 (Authorizing Care with a Legal Nonlicensed Provider).

· A provider that is not exempt from licensing bills for care outside the terms of their license and/or during a time when they are not licensed. See Chapter 11.3 (Licensed Child Care Providers), Chapter 11.6 (Certified License Exempt Centers), and Chapter 11.9 (Legal Nonlicensed (LNL) Providers).

Family and provider overpayments

If both the family and the provider benefit, assign an overpayment to both parties.

Overpayments can be assigned to the family and provider only when both the family and the provider acted together to intentionally cause the overpayment. This means that both parties committed an Intentional Program Violation (IPV) and have been disqualified for fraud. See Chapter 13.3 (Fraud Referrals), Chapter 13.6 (Disqualification for Wrongfully Obtaining Assistance – Families), and Chapter 13.9 (Disqualification for Wrongfully Obtaining Assistance – Providers). Both parties are jointly liable for the overpayment, regardless of who benefited from it. Recover the overpayment as outlined in Chapter 14.9 (Recovery Methods).

After the family or provider has completed their fraud disqualification period, as long as either party is in compliance with a repayment agreement, the party in compliance is eligible to receive child care assistance or to care for children receiving child care assistance, even if the other party is noncompliant with repayment arrangements. Once a family or provider becomes eligible again, the recovery method for that party switches from repayment to recoupment.

Step two: Recoup or recover from the party who benefited

See Chapter 14.9.6 (Recoupment – Families) and Chapter 14.9.9 (Recoupment – Providers).

Legal authority

Minnesota Statutes 142E.01, subd. 23
Minnesota Statutes 142E.11
Minnesota Statutes 142E.14, subds. 2 & 3
Minnesota Statutes 142E.16, subds. 7 & 8
Minnesota Rules 3400.0187