65A-1.900. Overpayment and Benefit Recovery  

Effective on Monday, November 26, 2018
  • 1This section sets forth the administrative policies applicable to the establishment and recovery of overpayments in the food assistance and cash assistance programs.

    24(1) Administrative Definitions Applicable to Overpayment and Benefit Recovery.

    33(a) Adult, for the purpose of this rule, is:

    421. Eighteen years of age or older;

    492. A teen parent receiving public assistance for themselves as an adult;

    613. An emancipated minor; or

    664. An individual who has been married even if the marriage ended in divorce.

    80(b) Cash Assistance, for the purposes of this rule includes, Temporary Cash Assistance, Work and Gain Economic Self-Sufficiency, Aid to Families with Dependent Children and Temporary Assistance for Needy Families.

    110(c) Delinquency, for the purposes of the Treasury Offset Program (TOP), is the failure to sign a Voluntary Repayment Agreement.

    130(d) Intentional Program Violation (IPV) or fraud, is defined pursuant to sections 142414.39(1), 143(2) and (4), F.S., 1477 C.F.R. §273.16(c) 150and 15145 C.F.R. §235.110(a)(2). 1547 C.F.R. §273.16 157(2016) and 15945 C.F.R. §235.110 162(2016) 163http://www.flrules.org/Gateway/reference.asp?No=Ref-08254, 165are incorporated by reference and may be obtained by contacting the Office of Public Benefits of Integrity, Department of Children and Families, 1317 Winewood Blvd., Tallahassee, Florida 32399.

    193(e) Overpayment, is the amount of public assistance received for which an individual or assistance group is not entitled.

    212(f) Direct Reimbursement, Repayment is the repayment by an individual 222or assistance group 225to the Department or contractor 230for an overpayment claim. Repayment may be sought by the individual payee or  assistance group members who met the criteria in subsection (1) of this rule.

    256(g) Recoupment of Benefits, is the deduction of repayment amounts from benefits prior to disbursing them.

    272(h) Refusal to Repay, occurs when the individual responsible for repayment:

    2831. Received notification of the overpayment or request for Voluntary Repayment Agreement as specified in subsection (8), and subsequently:

    302a. Fails to comply with the time frames as set forth in paragraph (8)(c);

    316b. Advises the Department either orally or in writing that they refuse to repay the amount owed; or

    334c. Fails to sign and return a Voluntary Repayment Agreement and repayment, which must be made in whole or in part by payment.

    357(i) Notification, for purposes of this rule, is any correspondence from the Department that advises an individual 374or assistance group 377of the status of an overpayment. Any notification will be in compliance with 3907 C.F.R. §273.18(e)(3). 3937 C.F.R. §273.18 396(2016) 397http://www.flrules.org/Gateway/reference.asp?No=Ref-08254, 399is incorporated by reference and may be obtained by contacting the Office of Public Benefits of Integrity, Department of Children and Families, 1317 Winewood Blvd., Tallahassee, Florida 32399.

    427(j) Extreme hardship policy, only to cash assistance agency errors and occurs when monthly expenses for basic maintenance needs exceed monthly income. Expenses taken into account include food, shelter, medical, transportation, clothing and personal and household incidentals, child or adult care and court ordered child support payments. Any expenses paid by someone outside the household are not used. The Department requires verification 489documentation for all extreme hardships494.

    4951. Food expenses exclude food assistance benefits.

    5022. Shelter expenses include rent, mortgage, mandatory maintenance or membership fees; loan repayments, including interest for the purchase of a mobile home; property taxes and insurance on the home; cost of fuel, electricity, water, sewerage and garbage pickup; and the basic service fees for one telephone.

    5483. Medical expenses include those not paid by insurance.

    5574. Transportation expenses include those necessary for household vehicles or public transportation.

    5695. Clothing and personal and household incidental expenses include those necessary for individuals in the household.

    5856. Child or adult care expenses include those costs paid to someone not residing in the household.

    6027. Court ordered child support payment expenses include those paid to someone not residing in the household.

    619(2) Individuals Responsible for Repayment of Overpayment.

    626(a) Individuals who received cash assistance overpayments as an adult will be responsible for repayment of the overpayment.

    644(b) 645Individuals who received f649ood assistance overpayments 652as an adult 655will be 657responsible for repayment 660as specified in 6637 C.F.R. §273.18(a)(4) 666(2015), incorporated by reference.

    670(c) Individuals who received Medicaid overpayments as an adult will be responsible for repayment of the overpayment.

    687(d) Adults who apply for and/or receive assistance on behalf of others.

    699(e) 700Authorized/Designated Representative, for purposes of this rule, means an individual who has knowledge of the assistance group’s circumstances and is authorized to act responsibly on their behalf.

    727(3) Monthly Repayment Amounts.

    731(a) The monthly repayment amounts of all public assistance are subject to negotiation.

    7441. Any individual 747or assistance group adversely 751affected by the preceding subparagraph is entitled to a departmental review or hearing pursuant to chapter 65-2, F.A.C.

    769(b) Any adult who applied for and/or received Medicaid benefits for themselves or the assistance group is liable or responsible for repayment. They will negotiate a repayment agreement with the Department or contractor.

    802(4) Methods of Repayment.

    806(a) The methods of repayment of cash assistance overpayment are as follows:

    8181. As specified in 82245 C.F.R. §233.20(a)(13) 825(2016), 82645 C.F.R. §233.20 829(2016) 830http://www.flrules.org/Gateway/reference.asp?No=Ref-08254, 832is incorporated by reference and may be obtained by contacting the Office of Public Benefits of Integrity, Department of Children and Families, 1317 Winewood Blvd., Tallahassee, Florida 32399; 860or

    8612. Through application of child support credit. Child support credit exists when child support collected and retained by the state during any month in which overpayment occurred exceeds the amount of cash assistance to which the assistance group was entitled for that month after computation of the overpayment has been completed. The excess amount of child support can, if requested by the absent parent or recipient, be credited as repayment and the amount owed by the individual responsible for repayment will be reduced by that amount. In addition, all or part of the overpayment claim can be satisfied should the absent parent of an overpaid assistance group repay to the Department all cash assistance benefits received on behalf of the overpaid assistance group. Child support credit is not applicable to RAP overpayments.

    993(b) The method of repayment of all food assistance overpayment will be as specified in 10087 C.F.R. §273.18(f)-1011(g).

    1012(c) For purposes of this rule, Medicaid overpayments will be collected by repayment.

    1025(5) Refusal to Repay. When an individual 1032or assistance group 1035refuses to make repayment after a request to do so, the Department, at its discretion, may take appropriate civil action against the income or resources of the individual 1063or assistance group 1066involved.

    1067(6) Compromising Food Assistance Claims. Effective August 1, 2001, a food assistance claim or any portion of a food assistance claim may be compromised with the exception of court ordered restitutions or IPVs. The Department reserves the right to approve or not approve the compromise.

    1112(a) Individuals with an overpayment claim in food a1121ssistance 1122may request a compromise of their claim 1129using the compromise request included in the Notice of Case Action Form BVFSOE. If a prior request has been decided, then any pending request is bound by the prior decision, unless the individual or assistance group can demonstrate a change in circumstances1171.

    1172(b) For purposes of a compromise request made pursuant to this rule, the Department will determine that the economic household circumstances reasonably demonstrate the overpayment claim will not be paid within three years of being notified of the overpayment claim. 1212For purposes of this paragraph, the three-year period is 36 months after the date of the Notice of Case Action. A claim 1234and will be compromise to zero dollars when at least one of the following is present:

    12501. The death or prognosis of death of any liable individual within three years of being notified;

    12672. Pending litigation 1270which shall not include administrative fair hearings or appeals of final orders from administrative fair hearings but does include proceedings of 1291a bankruptcy court, that involves any liable individual’s obligation to repay the overpayment within three years of being notified;

    13103. Any liable individual is sentenced to a period of incarceration that will expire after the three-year period the overpayment is expected to be paid;

    13354. The liable individual(s) sole household’s income is based only on either elderly age or disability projecting a fixed, limited economic potential to repay the overpayment within three years; or

    13655. Other reasons for a compromise. The Department will not speculate about the liable individual’s ability to repay the overpayment. If the Department must speculate, the Department will deny the request and provide written notice of the decision.

    1403(c) 1404At the time of the compromise request, the individual or assistance group shall submit 1418verification of subparagraphs 1. through 5., above. When a decision is made concerning the compromise request, the Department will provide written notice of the decision including information about hearing appeal rights.

    1449(7) Computation of Overpayment.

    1453(a) Overpayment computations will be made using the applicable program policies in effect during the certification period in which the overpayment occurred.

    1475(b) When the Department determines that it needs additional documentation of expenses to compute overpayment, it will notify the individuals 1495or assistance groups 1498responsible for repayment of the information needed. The individual 1507or assistance groups 1510must provide any requested items within the time requested by the Department, or the expense will not be considered in computing the overpayment amount.

    1534(8) Notification of Overpayment. The Department must notify the individuals 1544or assistance groups 1547responsible for repayment of overpayment in writing that overpayment exists and that they are required, by law, to repay the entire amount pursuant to Section 1572414.41(1), F.S., 1574or that they may seek compromise of a food assistance overpayment pursuant to 15877 C.F.R. §273.18(e)(3), 1590and (7).

    1592(a) The individual has a right to an administrative hearing in accordance with the Department’s hearings procedures in chapter 65-2, F.A.C.

    1613(b) The Department will send notification of overpayment to current and prior recipients by regular mail at the address the Department sends benefits or correspondence. The Department presumes delivery unless the postal service returns the notice to the Department. 1652For the purposes of this rule, mail shall be defined as outlined in subsection 166665A-1.203(12), 1667F.A.C.

    1668(c) The assistance group or individuals that receive notification will be considered to have refused to repay when they fail to contact the Department within 169330 days from the date of notification for all food assistance or cash assistance errors including cash assistance errors for the Refugee Assistance Program (RAP) and Optional State Supplementation (OSS) Programs.

    1724(9) Claim Thresholds. The Benefit Recovery Program will not pursue a claim in bankruptcy proceedings if the amount of the claim is at or below $1,250.

    1751(10) Determination of Intentional Program Violation.

    1757(a) Pursuant to sections 1761414.33, 1762414.36 1763and 1764414.39, F.S., 1766when the Department has information that an individual 1774or assistance group 1777has committed fraud 1780or an IPV, 1783it will refer the case to the Department of Financial Services, Division of Public Assistance Fraud (DPAF) for investigation. In cases where DPAF determines that an individual has committed fraud in the cash assistance or Food Assistance Programs, it will pursue a determination of IPV through either court action, administrative disqualification hearing, or both, where permitted by 18407 C.F.R. §273.16(a) 1843(2015), 184445 C.F.R. §235.110 1847(2015) and Section 1850414.41, F.S. 1852DPAF will pursue a determination of IPV through court action in instances where it determines that an individual has committed fraud in the Medicaid Program.

    1877(b) Individuals found by an administrative fair hearing officer or court to have committed an act of IPV while receiving, or attempting to receive, food assistance, cash assistance, or both will be disqualified from participation in the program(s) under which that act was committed or attempted in accordance with 19267 C.F.R. §273.16(b) 1929(2016), or section 1932414.41, F.S.

    1934(11) Treasury Offset Program.

    1938(a) The Department will refer individuals who owe past-due, legally enforceable federal food assistance overpayment debts to the U.S. Department of the Treasury for purposes of collection of such debt through offset against federal payments pursuant to 197526 U.S.C. §6402 1978(d)(1)-(2) and (f). Referral of individuals owing such debt will be completed in accordance with procedures and criteria contained in 199826 C.F.R. §301.6402-6 2001and 200231 C.F.R. Part 5 2006Subpart C et. seq., as provided for in 20147 C.F.R. §3.46. 201726 U.S.C. §6402 2020(2016), 202126 C.F.R. §301.6402-6 2024(2016), 202531 C.F.R. Part 5 2029Subpart C (2016) and 20337 C.F.R. §3.46 2036(2016) 2037http://www.flrules.org/Gateway/reference.asp?No=Ref-08254, 2039are incorporated by reference and may be obtained by contacting the Office of Public Benefits of Integrity, Department of Children and Families, 1317 Winewood Blvd., Tallahassee, Florida 32399.

    2067(b) A past-due, legally enforceable debt exists when an individual in receipt of overpayment as defined in section 2085414.41(1), F.S. 2087and paragraph (1)(e) of this rule, is at least 120 days delinquent in repayment of the such overpayment, and the overpayment has not been discharged through administrative or legal action.

    2117(c) The Department must make a reasonable attempt as defined in 212826 C.F.R. §301.6402-6(d), 2131to notify individuals owing such debt that:

    21381. The debt is past due; and,

    21452. Unless 2147a signed Voluntary Repayment Agreement and payment is received 2156within 60 days from the date on the notification, it will refer the debt to the U.S. Department of the Treasury for offset; and,

    21803. The individual debtor has 60 days from the date of notification to 2193request a review in writing, 2198via presentation of evidence to the Department, that all or part of the debt is not past-due or legally enforceable.

    2218(d) The Department will consider evidence presented timely by an individual in receipt of notification described in subparagraph (11)(c)3., above, that indicates all or part of their debt is not past-due or legally enforceable, and will make a determination as to the status of that debt prior to referral for offset. 2269The Department will notify the individual within thirty (30) days from the receipt of the review request. If it is found that the debt is past due and legally enforceable, the individual will be notified that they may request a Federal review by Food and Nutrition Services (FNS). 2317This consideration process is separate and apart from the fair administrative hearings appeals process and will address only the past-due status or legal enforceability of all or part of the debt.

    2348(e) The Department will provide a toll free telephone number for use in obtaining information concerning the offset.

    2366(12) The following forms, incorporated by reference, 2373and, unless otherwise stated, available at 2379http://www.flrules.org/Gateway/reference.asp?No=Ref-08254, 2381are used by the Department in the process of establishing and recovering overpayment:

    2394(a) Request for Additional Information, CF-ES 3400, 09/2009;

    2402(b) Waiver of Administrative Disqualification Hearing With a Program Loss, CF-ES 3410, Feb 2018, 2416available at 2418http://www.flrules.org/Gateway/reference.asp?No=Ref-09358;

    2420(c) Waiver of Administrative Disqualification Hearing Without a Program Loss, CF-ES 3410A, Feb 2018, 2434available at 2436http://www.flrules.org/Gateway/reference.asp?No=Ref-09359;

    2438(d) Disqualification Consent Agreement, CF-ES 3414, 11/2007;

    2445(e) Notice of Compromise Decision, CF-ES 3110, 03/2010; and,

    2454(f) Request for Information to Determine Compromise, CF-ES 3111, 03/2010.

    2464(g) Notice of Case Action, CF-ES:

    24701. BVFSOI, 12/2010;

    24732. BVFSOE, 12/2010;

    24763. BVCAOP, 12/2008;

    24794. BVMAOP, 12/2008;

    24825. BVPFBI, 12/2008;

    24856. BVPFBE, 12/2008;

    24887. BVPCBL, 12/2008;

    24918. BVPMBL, 12/2008;

    24949. BV06D5, 12/2008;

    249710. BV10D5, 12/2008;

    250011. BV06D6, 12/2008;

    250312. BV10D6, 12/2008;

    250613. BV06D9, 12/2008;

    250914. BV10D9, 12/2008;

    251215. BV06DF, 12/2008;

    251516. BV10DF, 12/2008;

    251817. BV06DA, 12/2008;

    252118. BV10DA, 12/2008;

    252419. BV06DG, 12/2008;

    252720. BV10DG, 12/2008;

    253021. BV06DB, 12/2008;

    253322. BV10DB, 12/2008;

    253623. BV06DH, 12/2008;

    253924 BV10DH, 12/2008;

    254225 BV11OH, 12/2008;

    254526. BV11OD, 12/2008;

    254827. BVEBBL, 12/2008;

    255128. BV12OS, 12/2008.

    2554(h) Treasury Offset Notification Letter 9/2016; and,

    2561(i) Treasury Offset Review Decision Notice 9/2016;

    2568(j) Management Review Notice, CF-ES 2341, Feb 2018, available at 2578http://www.flrules.org/Gateway/reference.asp?No=Ref-09355;

    2580(k)2581Trafficking Waiver of an Administrative Hearing, CF-ES 2372, Feb 2018, 2591available at 2593http://www.flrules.org/Gateway/reference.asp?No=Ref-09356; 2595and

    2596(l)              2597Notification of Intent to Disqualify, CF-ES 3056, September 2018, 2606available at 2608http://www.flrules.org/Gateway/reference.asp?No=Ref-100892610.

    2611Copies of the forms and materials incorporated by reference are available from the 2624Office of Public Benefits Integrity Headquarters, 26301317 Winewood Boulevard, Tallahassee, Florida 32399-0700. Forms are also available on the Department’s website at http://www.dcf.state.fl.us/dcfforms/Search2646/2647DCFFormSearch.aspx.

    2648Rulemaking Authority 2650414.41, 2651414.45 FS. 2653Law Implemented 2655414.31, 2656414.36, 2657414.41 FS. 2659History–New 7-21-92, Amended 1-5-93, 9-5-93, Formerly 10C-1.900, Amended 7-9-98, 4-2-00, 2-26-02, 3-18-03, 7-21-05, 1-19-09, 6-21-10, 5-24-17, 6-4-18, 11-26-18.


Rulemaking Events:

Historical Versions(5)

Select effective date to view different version.