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, or food 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:
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.
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.
For all programs except Child Care, claims (individual program or combined) of $0 to $1000, including instances of attempted fraud that would have resulted in an overpayment from $1 to $1000, if not discovered, will be referred to the Administrative Disqualification Hearing Officer . Claims of $1001 and over will be referred to the fraud unit who will determine how to proceed – civil, criminal or an Administrative Disqualification Hearing.
For Child Care, client overpayment claims of $0 to $2500, including instances of attempt client fraud that would have resulted in a child care overpayment from $0 to $2500, if not discovered, will be referred to the Administrative Disqualification Hearing Officer. Claims of $2501 and over will be referred to the fraud unit who will determine how to proceed. Child Care Provider overpayment claims of $0 to $5000 will be considered Vendor Overpayments and repayment action initiated. Claims of $5001 and over will be referred to the fraud unit who will determine how to proceed – civil or criminal.
NOTE: Exceptions can be made to the above policy depending on the situation. For example, a client that has already been disqualified at an Administrative Disqualification Hearing and has another fraudulent overpayment of less than the above amounts may be referred to the fraud unit instead of having a second hearing. Questionable situations should be discussed with the fraud unit for guidance.
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:
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 (Benefits Card). Fraud also includes the sale of, or intent to sell, food assistance benefits and/or Kansas Benefits Cards in public or online through Web sites and social media such as Craig’s List, Facebook, Twitter, eBay, etc.