B-950, OIG Responsibilities

Revision 20-4; Effective October 1, 2020

All Programs

OIG Benefits Program Integrity (BPI) is organized as follows:

  • Research Analysis and Policy Training (RAPT) unit;
  • Central Disqualification Unit (CDU);
  • Claims Investigations (CI) units; and
  • Field Investigations (FI) units.

The EBT Trafficking unit is also part of the OIG Investigations division and works closely with BPI.

OIG staff:

  • review allegations of HHSC benefit program recipient fraud, including employee, recipient or retailer EBT trafficking fraud;
  • investigate allegations of recipient or employee fraud to determine whether fraud exists and, if applicable, the amount of an overpayment;
  • establish fraud claims through the Fiscal Management Services Accounts Receivable Tracking System (ARTS);
  • coordinate with the HHSC Fair and Fraud Hearings Division for investigations submitted for ADH;
  • coordinate with the local district attorney office for investigations submitted for prosecution;
  • coordinate with U.S. Department of Agriculture (USDA) EBT trafficking investigations;
  • dispose investigations based on the results of either prosecution or ADH;
  • impose an IPV disqualification penalty, if applicable; and
  • coordinate with the HHSC-OSS – Eligibility Operations Customer Care Center (CCC) to adjust active HHSC program benefit amounts, if appropriate.

B—951 Facts Do Not Support an IPV

Revision 15-4; Effective October 1, 2015

All Programs

The facts do not support an IPV when:

  • OIG staff review and determine that the facts do not support the allegation,
  • a court determines the person is not guilty, or
  • an ADH hearing officer determines that no IPV was committed.

OIG staff may process these claims as inadvertent household errors/misunderstandings.

B—952 Facts Support an IPV

Revision 15-4; Effective October 1, 2015

All Programs

When OIG determines that the facts support an IPV allegation, OIG submits the case to either the:

  • local district attorney for prosecution, or
  • Fair and Fraud Hearings Division for an ADH.

Note: A person may waive the right to an ADH by signing Form OIG5040, which allows OIG to establish a fraud claim and impose an IPV disqualification.

B—953 Enforcement of IPV Disqualification

Revision 15-4; Effective October 1, 2015

TANF and SNAP

OIG-CDU staff enforce the IPV Disqualification and associated disqualification penalty.

B—953.1 Notice of an IPV Disqualification

Revision 15-4; Effective October 1, 2015

TANF and SNAP

CDU staff receive the following notices that a household member has been disqualified due to an IPV:

  • Form H1856, SNAP Out-of-State Intentional Program Violations. TW staff submit this form to CDU upon discovery of a person's current IPV disqualification that was administered by another state. See B-941, Disqualifying a Household Member with a Current SNAP Out-of-State IPV Disqualification, for directions.
  • Form OIG5038, Notice of Disqualification Decision. OIG staff submit this form to CDU indicating when a court finds a person guilty of an IPV, or a court defers adjudication and the person voluntarily signs Form OIG5036, Disqualification Consent Agreement.
  • Form OIG5040/5040S, Waiver of Disqualification Hearing. OIG staff submit this form to CDU indicating when a person waives the right to an ADH.
  • Form H4857, Notice of Decision, Administrative Disqualification Hearing. ADH hearing officers submit this form to CDU indicating the ADH decision that a person committed an IPV.

B—953.2 Imposing an IPV Disqualification

Revision 15-4; Effective October 1, 2015

TANF and SNAP

CDU staff has primary responsibility for enforcing IPV disqualifications upon receipt of:

  • Form H1856, SNAP Out-of State Intentional Program Violations;
  • Form OIG5040, Waiver of Disqualification Hearing, signed by the person;
  • Form H4857, Notice of Decision, Administrative Disqualification Hearing; or
  • Form OIG5038, Notice of Disqualification Decision.

CDU imposes the IPV disqualification penalty:

  • by the court-specified date (as indicated on Form OIG5038);
  • within 45 days of the court disqualification decision date (as indicated on Form OIG5038) if the court did not specify a disqualification date;
  • within 45 days of the date the person signs Form OIG5036, Disqualification Consent Agreement;
  • the first month after the date the local OIG office receives a signed Form OIG5040; or
  • the month after the date the person receives Form H4857.

CDU enters the IPV disqualification details in the disqualified individual's IPV Sanction screen and:

  • sends an email request to the OSS - Eligibility Operations CCC to rebudget the household's future SNAP EDG benefit amount when the interface record exceptions out of a mass update or the IPV was manually entered by OIG staff; and
  • sends Form OIG5042, Notice of Disqualification Enforcement, notifying:
    • the household of:
      1. the begin and end dates of the IPV disqualification penalty period; and
      2. its new benefit amount (if applicable); and
    • TW staff of the enforcement of the IPV disqualification penalty.

When an IPV disqualification is not imposed in a timely manner, CDU staff initiate an overpayment referral to establish an agency error overpayment claim for any months the household received benefits to which it was not entitled.

B—953.3 Amendment of IPV Disqualification Penalties

Revision 15-4; Effective October 1, 2015

All Programs

CDU staff are authorized to modify IPV disqualification information if applicable. TW staff should contact CDU if TW staff believe IPV information is incorrect. CDU will research and respond to the problem.