Overpayments 400-28-150-15

(Updated 9/1/2024 ML 3862)

There is a policy change effective 4/1/2026. View the Changes here.

An overpayment is a correction to benefits paid to a provider or adult member of the Child Care Assistance unit who was originally paid more than they were entitled to receive.

Overpayments are only established for errors caused by the client or provider due to failure to notify the Human Service Zone (HSZ) of a mandatory reportable change, fraud or an Intentional Program Violation (IPV).

Overpayments will be established for a provider in the following situations, and as determined by Child Care Assistance Policy:

When a provider certifies a child is in their care, but there are no attendance records to verify the child attended.
When a provider certifies a child will be attending for the future month, however the child does not attend a minimum of 8 hours.

EXCEPTION: When a child has attended at least 8 hours in one month, but does not attend in the following month, the first following month will not be considered an overpayment if the provider did not have knowledge that the child would not be attending.
A provider, who terminates services with the parent during the month, must reimburse the Department for the days care was not provided.
The enrollment amount or amount charged changes after payment has been issued.

Overpayments are not established due to agency errors.

EXCEPTION:

Overpayments will be pursued when duplicate payments are issued, or the incorrect provider is paid.

Example 1: At the time of application, the eligibility worker fails to request verification of the household’s income. The application is approved and payments are issued over the course of the eligibility period. It is later discovered that income verification was not requested or received. No overpayments are established as the agency failed to request verification of income.

Example 2: At the time of application, the household verified income eligibility below the income limit. During the eligiblty period, the household had an increase in income that resulted in income over the maximum allowable income limit but the household failed to report this change. In this situation, overpayments will be established as the household failed notify the county of the mandatory reportable change.

Example 3: At the time of application, the household was approved with mom and child. The father of the child moves into the home three months after the initial eligibility determination and is not engaged in an allowable activity. The household does not report the addition of father in the home. No overpayments are established as the addition of a household member is not a mandatory reportable change.

Example 4: A provider has been certifying within the Provider SSP that a child that is eligible for CCAP is in their care. It is later discovered that the child for whom the provider billed was not attending child care with that provider. In this situation, overpayments will be established and IPV may be pursued against the provider, household or both.

Example 5: A provider has been providing care for a child and certifies for the month of September for this child. On September 5th, the provider reports the child has not attended, and that the child will not be returning. The provider reports this was not reported to them until September 5th, the month of September will not be pursued as an overpayment.

The eligibility worker must promptly take all reasonable and practical steps to establish all overpayments.

Anytime an overpayment is discovered, a determination must be made whether or not to pursue an Intentional Program Violation.

When it is determined that an overpayment exists, each service month that is potentially incorrect must be reworked using the policies, procedures and information that should have been applied for those months.