INSTRUCTIONS TO STAFF 340:65-9-1
1. (a) When the worker determines that an overpayment claim has occurred, he or she documents the circumstances leading to the overpayment and computes the amount using the Oklahoma Program Integrity (OPI) system within 30 days of discovery. Documentation includes:
(1) the circumstances which caused ineligibility for benefits;
(2) monthly gross income and allowable monthly deductions including date employment began and receipt date of first check.
(3) unearned income and receipt date of first payment;
(4) resources which exceeded allowable standards and amount of highest known resource during the overpayment period;
(5) the exact date the worker learned that a possible overpayment occurred, the months there was complete ineligibility, and those months in which there was partial ineligibility; and
(6) a specific statement whether the overpayment was a result of household or agency error (AE) per
(b) The OPI system retrieves paid benefits information and calculates the overpayment amount based on information provided by the worker.
2. Office of Inspector General (OIG) staff documents the circumstances leading to the overpayment, including income, resources, or other necessary verification, and sends the information to the Family Support Services Division (FSSD) Benefit Integrity and Recovery Section (BIRS) staff who computes the amount using the OPI system.
3. Prior to completion, the overpayment claim is shown in pending status in OPI. The establishment of an overpayment is made by the worker's supervisor or staff in the FSSD BIRS within the OPI system.
(1) The worker and supervisor establish any overpayment under $500 due to inadvertent household error (IHE) and any AE overpayment regardless of the amount.
(2) FSSD BIRS staff establish all overpayments $500 and over not due to AE, all overpayments referred by OIG, and all overpayments due to fraud after a determination of fraudulent intent has been made by OIG through the judicial system, an administrative disqualification hearing (ADH), or a signed Form 19MP002E, Disqualification Consent Agreement, or Form 08OP002E, Affidavit of Acknowledgement of Indebtedness.
(3) OPI forwards pending overpayments that are not established by HSC staff to the FSSD BIRS. FSSD BIRS staff reviews these overpayments and, if appropriate, forwards them for investigation to OIG through the OPI system. Once OIG staff completes the investigation, the overpayment is sent back to the FSSD BIRS through OPI to establish the overpayment.