11200 DETERMINATION OF FRAUD

 

Any individual who is suspected of committing fraud for the purpose of improperly establishing or maintaining eligibility for cash, child care, food assistance, or medical assistance benefits shall be referred to the Fraud Unit or Administrative Disqualification Hearings Officer as appropriate for a determination of fraud.

 

An individual may be found guilty of fraud by any one of the following methods:

 

  1. For cash assistance except RE, and Food Assistance: When the individual has been legally determined to have committed fraud through a court of appropriate jurisdiction;
     

    By the individual signing a disqualification consent agreement in cases referred for prosecution;

     

    When the individual has been established as having committed fraud through an Administrative Disqualification Hearing; or
     

    By the individual signing a Waiver of Right to a Disqualification Hearing form.
     

    For medical assistance, child care and RE, when the individual has been legally determined to have committed fraud through a court of appropriate jurisdiction.
     

    A referral may be made to the Administrative Disqualification Hearing Officer (ADHO) or to the local Fraud Unit regardless of the current eligibility of the individual.
     

NOTE: Since the Food Assistance Program is 100% federally funded and a nationwide entitlement program, fraud determinations made in one state are valid and countable in another.

 

11210 Definition of Fraud - Fraud is defined as having intentionally:
 

  1. Made a false or misleading statement, misrepresentation, concealment, or withholding of facts for the purpose of improperly establishing or maintaining eligibility; or

  1. For food assistance, committing any act that constitutes a violation of the Food and Nutrition Act of 2008, the Food Assistance Program Regulations, or any Kansas statute relating to the use, presentation, transfer, acquisition, receipt, or possession of food assistance access devices (Vision Card).

     

  2. For medical assistance, the misuse of medical benefits, including selling, sharing or trading the medical I.D. number for money or other remuneration; signing for services that were not provided to the recipient; or other misuse as determined by the Kansas Health Policy Authority. A finding of fraud under these provisions may result in a criminal penalty, including fines and imprisonment, but does not result in a period of ineligibility (see 11221 (4)).