Participant Overpayments

PURPOSE: This rule establishes procedures to use when determining and collecting child care subsidy overpayments made to participants. (1) Overpayments. All child care subsidy participant overpayments shall be subject to repayment from a participant up to the full amount of the overpayment. (A) If the department determines that it has made an overpayment on behalf of a participant, as a result of agency error, participant error, fraud, intentional violations, unintentional violations, or inadvertent error, the department shall provide written notice to the participant. The department shall send the notification via first class mail to the participant’s address of record. The notification shall include— 1. The total amount of the overpayment; 2. The service date and/or dates; 3. The reason for the overpayment; and 4. The method in which the overpayment may be contested. (B) Notifications sent to participant’s address of record via first class mail shall constitute good service of notice. (C) If the participant wishes to contest the overpayment, the participant shall make a direct appeal to the director pursuant to section 208.080, RSMo, in writing within ninety (90) days of the date of the written notice of overpayment. (D) If the participant does not timely make a direct appeal to the director in writing, the department may proceed to collection of overpayment. (2) Direct Appeal to the Director. (A) If the participant timely makes a direct appeal to the director, the director shall designate the Administrative Hearings Unit of the Division of Legal Services of the Department of Social Services to hear all cases. The Administrative Hearings Unit shall hear cases under the procedures outlined in 13 CSR 40-2.160. (B) The department shall not seek collection or repayment of an overpayment until the hearing is completed and a decision rendered. (C) The burden shall be on the participant to prove there was no overpayment or that the overpayment was calculated incorrectly. (D) Upon completion of the hearing, the Administrative Hearings Unit shall issue a written decision as approved by the director, except in default cases or cases disposed of by stipulation, consent order, or agreed settlement. The decision shall include, or be accompanied by, findings of fact and conclusions of law. The findings of fact shall be stated separately from the conclusions of law and shall include a concise statement of the findings on which the agency bases its order. The Administrative Hearings Unit shall deliver or mail its decision, findings of fact, and conclusions of law to each party, or his/her attorney of record. The decision of the Administrative Hearings Unit shall be the final decision of the department. (3) Collection and Repayment. (A) Once the assessment of the overpayment is final, the department may utilize any and all procedures in law and equity to collect the overpayment. (B) The department and participant may enter into a voluntary repayment plan as follows: 1. The department and the participant shall negotiate a repayment plan within forty-five (45) days from the date the overpayment becomes final; 2. The repayment plan may include a single lump-sum payment or equal, monthly installment payments over a specified period of time; and 3. The department shall provide the negotiated repayment plan in writing to the participant. Every repayment plan that includes monthly installment payments shall also include a promissory note executed by the participant in favor of the Department of Social Services as provided by the department. The participant shall sign the repayment plan and promissory note, as applicable, and shall return the original, signed copy to the department. The participant shall then make payments as directed in the repayment plan and/or promissory note, as applicable. (4) Default. (A) An overpayment account shall be in default if— 1. The participant fails to negotiate a mutually agreeable repayment plan; 2. The participant fails to sign or return the repayment plan and/or promissory note; 3. The account is not subject to a repayment plan and the full amount is not repaid within ninety (90) days from the date of notice of overpayment or date of the Administrative Hearing Unit’s decision, whichever is later; or 4. The account is subject to a repayment plan and/or an installment payment, and is not received within thirty (30) days of the date that it is due. (B) If an overpayment is in default, the balance of the overpayment shall be immediately due and payable. (C) The department may take appropriate actions to recover default accounts, which may include, but are not limited to: 1. Filing a claim for debt off-set with the Director of Revenue to recover the overpayment from any refunds due to the participant by the Department of Revenue pursuant to section 143.781, RSMo; 2. Filing a cause of action in a court of competent jurisdiction; 3. Other action as allowed by state or federal law as deemed appropriate by the department. AUTHORITY: sections 207.020, 210.025, and 210.027, RSMo 2016,* 42 U.S.C. section 9858, et. seq., Executive Order 03-03. This rule originally filed as 13 CSR 35-32.100. Original rule filed Jan. 3, 2017, effective Aug. 30, 2017. Moved to 5 CSR 25-200.100, effective Aug. 28, 2021. *Original authority: 207.020, RSMo 1945, amended 1961, 1965, 1977, 1981, 1982, 1986, 1993, 2014; 210.025, RSMo 1999, amended 2004; and 210.027, RSMo 1999, amended 2014.