This business process flow shows the high level steps utilized to by the Child Care Provider Integrity Education and Support Unit to process child care provider overpayments.
Referrals to the Child Care Provider Integrity Education and Support Unit can be received from multiple sources including:
The Outlier Report
Fraud Navigator from EBT
DCF Staff
People Outside of the Agency
The Fraud Hotline
Random Audits
Provider reviews are indicated in the Journal associated to the child care provider and in the comments section of the Resource Detail page. A course of action is determined after provider information is collected and reviewed. If updates are needed to the Child Care program, an email is sent to the Purple Team. See the process guidelines below if further action is needed from the Child Care Provider Integrity Education and Support Unit.
Send the P917: Corrective Action Plan from KEES.
Notify the Child Care Provider Enrollment Staff (Resource Databank (RDB) Maintainer) to close the provider.
See Closing a Relative Child Care Provider or Closing KDHE Licensed and Child Care Centers for detailed steps on how to close a provider in KEES.
Complete a Resource Search in the RDB to find the Child Care Provider.
Edit the Resource Detail and Service Detail pages.
Update the status to ‘Closed’ on the Service Detail and Resource Detail page
Enter an EBT Closure Date
Update the Review Date on the Resource Detail page to 12/31/2999
Send the P201: CC Provider Denial/Termination Notice
NOTE: When a Child Care Provider Service is closed, KEES automatically closes all associated child care plans and sends the C506: Termination – Child Care Provider Agreement Ending via the Child Care Service Closed batch.
Consumer or Agency Overpayment (See Processing Overpayments for detailed steps):
Update the Data Collection pages as appropriate. See Non-Financial Data Collection, Financial Data Collection, and Child Care Data Collection for additional information on completing these pages.
Run EDBC for each overpayment month to create a ‘Pending’ Recovery Account.
Provider Overpayment:
Calculate the overpayment off system.
Create an External Recovery Account in ‘Pending’ status. See Creating an External Recovery Account for detailed steps.
Select ‘Vendor Overpayment’ from the Cause drop-down menu.
Send the C911: Child Care Benefit Repayment Agreement and/or P911: Provider Overpayment – Repayment Agreement as applicable.
Check for Repayment Agreement task generates in the Child Care RDB Enrollment queue after 15 days.
NOTE: Complete the Fair Hearing Process if an appeal is filed.
After 30 days, update the Recovery Account Detail page with a status of ‘Active’. See Processing Overpayments: Setting a Recoupment for detailed steps to begin a recoupment for the consumer.
Email the overpayment information to the Central Collection Unit (CCU).
Narrate in the consumer/provider Journals and document notifications were sent.
Consumer Fraud Overpayment (See Processing Overpayments for detailed steps):
Update the Data Collection pages as appropriate. See Non-Financial Data Collection, Financial Data Collection, and Child Care Data Collection for additional information on completing these pages.
Run EDBC for each overpayment month to create a ‘Pending’ Recovery Account.
Provider Fraud Overpayment:
Calculate the overpayment off system.
Create an External Recovery Account in ‘Pending’ status. See Creating an External Provider Recovery Account for detailed steps.
Select ‘Vendor Overpayment’ from the Cause drop-down menu.
Edit the ‘Pending’ Recovery Account to select a status reason of ‘Pending Fraud Prosecution’.
Send information to the Fraud Unit for Court Filing or the Office of Administrative Disqualification Hearings. See Administrative Hearings for detailed steps.
Update the Recovery Account Detail page to ‘Active’ status when a judgement is received. If the defendant is also a consumer, complete the Repayment Term Detail page. See Processing Overpayments: Setting a Recoupment for detailed steps.
NOTE: When a judgment is received, DCF Legal sends a copy of the judgment to CCU via email.
Send Notifications:
Provider: P911: Provider Overpayment – Repayment Agreement
Consumer: C911: Child Care Benefit Repayment Agreement and the Child Care & TANF Fraud Disqualification notification. Use the standard copy and paste text for the Child Care & TANF Fraud Disqualification notification.
Narrate in the consumer/provider Journals and document notifications were sent.
Provider and Consumer Recovery Accounts are always linked to a Case Number in KEES.
If benefits were issued out of KEES on a converted Child Care Family Plan, an External Recovery account is required for a Child Care overpayment.
Use the worker ID, DC3003E300, to assign a Recovery Account to CCU. See the Worker ID Code Table for more information.
When a consumer is convicted of Child Care fraud and there is an Active TANF program, the Child Care Provider Integrity Education and Support Unit should create a Non-Compliance record on the Eligibility Non-Compliance Detail page and notify the Purple team using the guidance below:
NOTE: Child Care Provider Integrity Education and Support Unit are responsible for applying the fraud conviction to the Child Care program and processing it as appropriate.
Name: Select the consumer’s name
Type: Fraud TANF and CC
Reason: 1st violation
Program Type: Select Child Care and TANF/RCA
Begin Date: Indicate the first day of the month the penalty should apply
When a consumer fails to cooperate with a Child Care fraud investigation and there is an Active TANF program, the Child Care Provider Integrity Education and Support Unit should create a Non-Compliance record on the Eligibility Non-Compliance Detail page, use the standard copy and paste text to notify the consumer, and notify the Purple team using the guidance below:
NOTE: Child Care Provider Integrity Education and Support Unit are responsible for applying the fraud conviction to the Child Care program and processing it as appropriate.
Name: Select the consumer’s name
Type: Quality Control
Reason: State QC Non-Coop
Program Type: Select Child Care and TANF/RCA
Begin Date: Indicate the first day of the month the penalty should apply
Comments: Indicate the consumer failed to cooperate with a Child Care fraud investigation.