Revision 12-2; Effective April 1, 2012

B—771 Filing an Overpayment Referral Using Automated System for the Office of Inspector General (ASOIG)

Revision 15-4; Effective October 1, 2015

All Programs

Staff create referrals for overpayments caused by agency error, individual error/misunderstanding, or suspected IPV or fraud in ASOIG.

ASOIG is accessed at the following website: https://hhsportal.hhs.state.tx.us/asoig.

Users log in using a unique sign on. A disclaimer page explaining IRS Federal Tax Information requirements must be agreed to before proceeding with the referral. Agreement takes the user to the ASOIG home page.

Investigation is selected from the left navigation menu to proceed to the Referral and Investigation search page. Users must enter identifying information and select Create Referral.

Identifying information may consist of one or more of the following:

• Suspect name,
• Individual (client) number,
• Social Security number, or
• EDG or case number.

The Create Referral tab takes the user to the Create Referral screen group. This consists of the Referral, Suspects, Reasons, Contacts, Comments and Assignment tabs. The user must go through all tabs, enter information as appropriate, and save the referral.

The Referral tab is the first tab in creating a referral. The tab has two areas. The top part, Alleged Information, is for entering biographical information. The bottom portion, EDG Types, is used to enter whatever program type information is known.

The New button at the bottom of the tab is used when adding types to the EDG Types portion of the tab. If the referral is associated with more than one EDG, users must click the New button to add additional types. The user must continue to click the New button until all EDGs associated with the referral are added. Once all types have been entered, the user must click the Next button to proceed to the next tab, Suspects.

The Suspects tab is used to enter information on suspects as well as household members associated with the referral. The top portion of the screen, Suspect, allows for the entry of any known biographical information. The bottom portion, Address, is for entering any known address(es).

At least one suspect screen with a name and type of suspect is required for a referral. Although children are not "suspects," entering all household members is recommended as that information will be required if an investigation is merited.

If an automated interface finds information in TIERS, users may select from a list of names. If a name is chosen from the list in this field, the ASOIG populates applicable biographical and EDG information such as date of birth, Social Security number and address. If TIERS information is not found, users must enter all known information.

The New button on the tab is to allow the user to include all household members in the referral. Once all members are entered, the user must click the Next button to advance to the next tab, Reasons.

The Reasons tab is used to establish the basis for the referral. The screen is divided into three sections, Reason, Source Information and Source Detail. One reason type and name is required for each referral.

Multiple reasons may be entered on a single referral. If there are multiple reasons, users enter the information for the first reason and then click the New button to enter information for the next reason. Once all applicable reasons are entered, the user must click the Next button to move to the next tab, Contacts.

The Contacts tab is used to enter sources of information such as another employee, agency or other person with information about the referral. The screen is divided into two sections. The Contact portion is for information on the source of information while the Address portion is for documenting any address information for the contact.

A Contacts entry is not required for a referral, but multiple entries may be made by clicking the New button. Clicking on the Next button takes the user to the next tab, Comments.

The Comments tab is used to enter information on the referral. It is used to document information not otherwise captured by ASOIG. At least one comment is required and multiple comments may be entered. Comments are listed by subject, and users should enter a concise statement in the subject to describe the contents of the comment.

Comments may be linked to a Contact by clicking the Related Contact checkbox.

Once a comment is saved by clicking the New or Next button, it cannot be modified. Care must be exercised in completing this tab. Clicking the Next button takes the user to the final tab, Assignment.

The Assignment tab allows the assignment of the referral based on predefined rules. Once the Save Referral button is clicked, the referral is saved and all information is locked, except for the ability of the user to include additional comments.

Saving the referral takes the user back to the Referral tab; however, it is only for viewing, and the user now has the ability to attach any electronic documents saved on the user's computer to the referral. Attach documents by clicking the paper clip icon next to the tabs, browse to select the document, give a name to the document, describe the contents of the document and click Save. Multiple documents may be attached using the New button.

Note: Logging out of the referral before it is saved on the Assignment tab will result in loss of information entered, requiring the user to start over.

B—772 Filing an Overpayment Referral Using TIERS

Revision 15-4; Effective October 1, 2015

SNAP and TANF

When eligibility staff discover that an overpayment exists, either by advisor knowledge or because it is identified in the TIERS Eligibility Summary, the following steps must be taken to enter the referral in TIERS:

• From the left navigation menu, the user must go to Data Collection > Initiate Interview and enter the case number and case mode. If a case is already in ongoing mode, the user may enter the referral.
• From the left navigation menu, the user must select Data Collection > Miscellaneous > Referral. The TIERS referral summary page will display. If an overpayment claim exists for the EDG, there will be an entry for the advisor to review on this page. To review the claim, the user must click on the edit icon.
• To enter a new referral, the user must click the red Add button.
• On the Details page, the user must enter the following information:
  • Name – From the drop-down menu, select the name of the individual causing the overpayment.
  • Effective Begin Date – Enter the date the overpayment began.
  • Discovery Code – From the drop-down menu, select the most appropriate entry to describe how the overpayment was discovered. If no entry is appropriate, select "other."
  • Error Referral Type – From the drop-down menu, select an entry based on the entity causing the error. For errors caused by the agency's error or failure to take action in a timely manner, select "agency." For errors caused by individuals without the intent to commit fraud, select "client." For errors where eligibility staff believe the individual intentionally committed fraud to receive additional benefits, select "fraud."
  • Overpayment Reason – From the drop-down menu, select the most appropriate reason for the overpayment. If no entry is appropriate, select "other."
  • Overpayment Discovery Date – Enter the date HHSC discovered the overpayment.
  • Benefit Type – From the drop-down menu, make the appropriate selection based on the type of benefit overpaid.
  • Financial Penalty Code – For overpayments caused by TANF Personal Responsibility Agreement (PRA) noncompliance, select the area with which the individual noncomplied.
  • Destination Unit – Select the appropriate unit by region and by the type of referral (CI – Claims Investigation/FI – Fraud Investigation).
  • Referral Benefit Restored Amount – If the overpayment was caused by the issuance of restored benefits, enter the overpayment amount in this field. If the overpayment was not caused by the issuance of restored benefits, a zero entry remains in this field.
  • Form 1898 Completion Date – This field is used for overpayment claims caused by the issuance of restored benefits only. Enter the date Form 1898, Restored Benefits Documentation, was completed at the time the restored benefits were authorized.
  • First Month and Year of Overpayment – Enter the month and year the overpayment began. Estimate only.
  • Last Month and Year of Overpayment – Enter the month and year the overpayment ended. Estimate only.
  • Overpayment Amount – Enter the dollar amount of the overpayment for all referrals except referrals based on restored benefits. If the overpayment was caused by the issuance of restored benefits, this field should contain a zero entry. Estimate only.
  • EDG Participation – For the individual causing the overpayment, select whether or not the individual was a member of the certified group.
  • Participation Change Date – For claims based on household changes, enter the date the participation status changed for the individual causing the overpayment.
  • Participation Change Report Date – For claims based on household changes, enter the date HHSC learned of the household change.
  • Enter comments you wish OIG to receive by entering page-level comments on this page – Click on the center icon next to the Referral – Details title to enter page-level comments.
• On the Income page (for overpayments caused by income only), if known, the user enters the following information:
  • Source Type – From the drop-down menu, select "earned income" or "unearned income" depending on the type of income causing the overpayment.
  • Source Name – Enter the name of the entity that provided the income that caused the overpayment. This may be the name of an individual, company or government agency.
  • Verification Source – From the drop-down menu, make the appropriate verification source selection. If the source used to verify the income is not available on the menu, select "none" and document the source in page-level comments on the details tab.
  • Source Hire Date – For earned income overpayments, enter the hire date for the individual.
  • First Check Date – Enter the date the individual received the first payment that caused the overpayment. Note: This could be a check or cash payment, and the payment could be for earned and unearned income.
  • Source Report Date – Enter the date the individual informed HHSC of the income change.
  • Source Amount – Type the monthly amount of the income received from the source.
  • Income Source Address – If known, enter the address of the income source.
• On the Resources page (for overpayments caused by resources only), if known, the user enters the following information:
  • Resource Type – From the drop-down menu, select the most appropriate entry for the type of resource causing the overpayment. If no selection is appropriate, select "other."
  • Resource Change Date – Enter the date the individual obtained possession of the resource.
  • Resource Report Date – Enter the date HHSC learned of the resource change.
  • Resource Amount – Enter the countable value of the resource.
• The user must document the overpayment referral and reason in TIERS Case Comments.