Revision 11-1; Effective January 1, 2011

All Programs

An overpayment is the amount of benefits issued in excess of what should have been issued.

A claim is an amount owed by an individual for an overpayment of benefits or owed by an individual for benefits that are trafficked.

The date of discovery is the date the Office of Inspector General (OIG) substantiates that an overpayment occurred.

B—711 Types of Overpayment Claims

Revision 15-4; Effective October 1, 2015

All Programs

There are three types of overpayment claims:

  • agency error,
  • inadvertent household error/misunderstanding, or
  • fraud or intentional program violation (IPV).

OIG staff process overpayment referrals, determine the overpayment amount, and submit as a claim to the Texas Health and Human Services Commission (HHSC) Fiscal Management Services (FMS) to collect.

Related Policy

Referrals for Intentional Program Violation (IPV), B-900