Code of Federal Regulations (alpha)

CFR /  Title 7  /  Part 273  /  Sec. 273.18 Claims against households.

(a) General. (1) A recipient claim is an amount owed because of:

(1) A recipient claim is an amount owed because of:

(i) Benefits that are overpaid or

(ii) Benefits that are trafficked. Trafficking is defined in 7 CFR 271.2.

(2) This claim is a Federal debt subject to this and other regulations governing Federal debts. The State agency must establish and collect any claim by following these regulations.

(3) As a State agency, you must develop a plan for establishing and collecting claims that provides orderly claims processing and results in claims collections similar to recent national rates of collection. If you do not meet these standards, you must take corrective action to correct any deficiencies in the plan.

(4) The following are responsible for paying a claim:

(i) Each person who was an adult member of the household when the overpayment or trafficking occurred;

(ii) A person connected to the household, such as an authorized representative, who actually trafficks or otherwise causes an overpayment or trafficking.

(b) Types of claims. There are three types of claims: ------------------------------------------------------------------------

(1) Intentional Program any claim for an overpayment or

violation (IPV) claim. trafficking resulting from an individual

committing an IPV. An IPV is defined in

Sec. 273.16.(2) Inadvertent household any claim for an overpayment resulting

error (IHE) claim. from a misunderstanding or unintended

error on the part of the household.(3) Agency error (AE) claim.. any claim for an overpayment caused by an

action or failure to take action by the

State agency.------------------------------------------------------------------------

(c) Calculating the claim amount--(1) Claims not related to trafficking. ------------------------------------------------------------------------

------------------------------------------------------------------------

(i) As a State agency, you------------------------------------------------------------------------must calculate a claim . . . and . . . and . . .

back to at least twelve for an IPV claim, for all claims,

months prior to when you the claim must be don't include any

become aware of the calculated back to amounts that

overpayment. the month the act occurred more than

of IPV first six years before

occurred. you became aware of

the overpayment.------------------------------------------------------------------------

(ii) The actual steps for calculating a claim are------------------------------------------------------------------------you . . . unless . . . then . . .

(A) determine the correct

amount of benefits for each

month that a household

received an overpayment.(B) do not apply the earned the claim is an AE apply the earned

income deduction to that claim. income deduction.

part of any earned income

that the household failed

to report in a timely

manner when this act is the

basis for the claim.(C) subtract the correct this answer is zero dispose of the claim

amount of benefits from the or negative. referral.

benefits actually received.

The answer is the amount of

the overpayment.

(D) reduce the overpayment you are not aware of the amount of the

amount by any EBT benefits any expunged overpayment

expunged from the benefits. calculated in

household's EBT benefit paragraph

account in accordance with (c)(1)(ii)(C) of

your own procedures. The this section is the

difference is the amount of amount of the

the claim. claim.------------------------------------------------------------------------

(2) Trafficking-related claims. Claims arising from trafficking-related offenses will be the value of the trafficked benefits as determined by:

(i) The individual's admission;

(ii) Adjudication; or

(iii) The documentation that forms the basis for the trafficking determination.

(d) Claim referral management. ------------------------------------------------------------------------

------------------------------------------------------------------------

(1) As a State agency, you------------------------------------------------------------------------must . . . and you . . . unless . . .

establish a claim before the will ensure that no you develop and use

last day of the quarter less than 90 your own standards

following the quarter in percent of all and procedures that

which the overpayment or claim referrals are have been approved

trafficking incident was either established by us (see

discovered. or disposed of paragraph (d)(2) of

according to this this section).

time frame.------------------------------------------------------------------------

(2) Instead of using the standard in paragraph (d)(1) of this section, you may opt to develop and follow your own plan for the efficient and effective management of claim referrals.

(i) This plan must be approved by us.

(ii) At a minimum, this plan must include:

(A) Justification as to why your standards and procedures will be more efficient and effective than our claim referral standard;

(B) Procedures for the detection and referral of potential overpayments or trafficking violations;

(C) Time frames and procedures for tracking claim referrals through date of discovery to date of establishment;

(D) A description of the process to ensure that these time frames are being met;

(E) Any special procedures and time frames for IPV referrals; and

(F) A procedure to track and follow-up on IPV claim referrals when these referrals are referred for prosecutorial or similar action.

(3) States must establish claims even if they cannot be established within the timeframes outlined under paragraph (d) of this section.

(e) Initiating collection action and managing claims--(1) Applicability. State agencies must begin collection action on all claims unless the conditions under paragraph (e)(2) of this section apply.

(1) Applicability. State agencies must begin collection action on all claims unless the conditions under paragraph (e)(2) of this section apply.

(2) Pre-establishment cost effectiveness determination. A State agency may opt not to establish and subsequently collect an overpayment that is not cost effective. The following is our cost-effectiveness policy for State agencies: ------------------------------------------------------------------------

------------------------------------------------------------------------

(i) You may follow your own cost effectiveness plan and------------------------------------------------------------------------opt not to establish any unless . . . or . . .

claim if . . .you determine that the claim you do not have a you already

referral is not cost cost-effectiveness established the

effective to pursue. plan approved by us. claim or discovered

the overpayment in

a quality control

review.------------------------------------------------------------------------

(ii) Or you may follow the FNS threshold and------------------------------------------------------------------------opt not to establish any unless . . . or . . .

claim if . . .you determine that the claim the household is you already

referral is $125 or less. currently established the

participating in claim or discovered

the Program. the overpayment in

a quality control

review.------------------------------------------------------------------------

(3) Notification of claim. (i) Each State agency must develop and mail or otherwise deliver to the household written notification to begin collection action on any claim.

(i) Each State agency must develop and mail or otherwise deliver to the household written notification to begin collection action on any claim.

(ii) The claim will be considered established for tracking purposes as of the date of the initial demand letter or written notification.

(iii) If the claim or the amount of the claim was not established at a fair hearing, the State agency must provide the household with a one-time notice of adverse action. The notice of adverse action may either be sent separately or as part of the demand letter. ------------------------------------------------------------------------

-------------------------------------------------------------------------(iv) The initial demand letter or notice of adverse action must include

(A) The amount of the claim.------------------------------------------------------------------------(B) The intent to collect from all adults in the household when the

overpayment occurred.------------------------------------------------------------------------(C) The type (IPV, IHE, AE or similar language) and reason for the

claim.------------------------------------------------------------------------(D) The time period associated with the claim.------------------------------------------------------------------------(E) How the claim was calculated.------------------------------------------------------------------------(F) The phone number to call for more information about the claim.------------------------------------------------------------------------(G) That, if the claim is not paid, it will be sent to other collection

agencies, who will use various collection methods to collect the claim.------------------------------------------------------------------------(H) The opportunity to inspect and copy records related to the claim.------------------------------------------------------------------------(I) Unless the amount of the claim was established at a fair hearing,

the opportunity for a fair hearing on the decision related to the

claim. The household will have 90 days to request a fair hearing.------------------------------------------------------------------------(J) That, if not paid, the claim will be referred to the Federal

government for federal collection action.------------------------------------------------------------------------(K) That the household can make a written agreement to repay the amount

of the claim prior to it being referred for Federal collection action.------------------------------------------------------------------------(L) That, if the claim becomes delinquent, the household may be subject

to additional processing charges.------------------------------------------------------------------------(M) That the State agency may reduce any part of the claim if the agency

believes that the household is not able to repay the claim.------------------------------------------------------------------------

(N) A due date or time frame to either repay or make arrangements to

repay the claim, unless the State agency is to impose allotment

reduction.------------------------------------------------------------------------(O) If allotment reduction is to be imposed, a due date or time frame to

either repay or make arrangements to repay the claim in the event that

the household stops receiving benefits.------------------------------------------------------------------------(P) If allotment reduction is to be imposed, the percentage to be used

and the effective date.------------------------------------------------------------------------

(v) The due date or time frame for repayment must be not later than 30 days after the date of the initial written notification or demand letter.

(vi) Subsequent demand letters or notices may be sent at the discretion of the State agency. The language to be used and content of these letters is left up to the State agency.

(4) Repayment agreements. (i) Any repayment agreement for any claim must contain due dates or time frames for the periodic submission of payments.

(i) Any repayment agreement for any claim must contain due dates or time frames for the periodic submission of payments.

(ii) The agreement must specify that the household will be subject to involuntary collection action(s) if payment is not received by the due date and the claim becomes delinquent.

(5) Determining Delinquency. (i) Unless specified in paragraph (e)(5)(iv) of this section, a claim must be considered delinquent if:

(i) Unless specified in paragraph (e)(5)(iv) of this section, a claim must be considered delinquent if:

(A) The claim has not been paid by the due date and a satisfactory payment arrangement has not been made; or

(B) A payment arrangement has been established and a scheduled payment has not been made by the due date.

(ii) The date of delinquency for a claim covered under paragraph (e)(5)(i)(A) of this section is the due date on the initial written notification/demand letter. The claim will remain delinquent until payment is received in full, a satisfactory payment agreement is negotiated, or allotment reduction is invoked.

(iii) The date of delinquency for a claim covered under paragraph (e)(5)(i)(B) of this section is the due date of the missed installment payment unless the claim was delinquent prior to entering into a repayment agreement, in which case the due date will be the due date on the initial notification/demand letter. The claim will remain delinquent until payment is received in full, allotment reduction is invoked, or if the State agency determines to either resume or re-negotiate the repayment schedule.

(iv) A claim will not be considered delinquent if another claim for the same household is currently being paid either through an installment agreement or allotment reduction and you, as a State agency, expect to begin collection on the claim once the prior claim(s) is settled.

(v) A claim is not subject to the requirements for delinquent debts if the State agency is unable to determine delinquency status because collection is coordinated through the court system.

(6) Fair hearings and claims. (i) A claim awaiting a fair hearing decision must not be considered delinquent.

(i) A claim awaiting a fair hearing decision must not be considered delinquent.

(ii) If the hearing official determines that a claim does, in fact, exist against the household, the household must be re-notified of the claim. The language to be used in this notice is left up to the State agency. The demand for payment may be combined with the notice of the hearing decision. Delinquency must be based on the due date of this subsequent notice and not on the initial pre-hearing demand letter sent to the household.

(iii) If the hearing official determines that a claim does not exist, the claim is disposed of in accordance with paragraph (e)(8) of this section.

(7) Compromising claims. (i) As a State agency, you may compromise a claim or any portion of a claim if it can be reasonably determined that a household's economic circumstances dictate that the claim will not be paid in three years.

(i) As a State agency, you may compromise a claim or any portion of a claim if it can be reasonably determined that a household's economic circumstances dictate that the claim will not be paid in three years.

(ii) You may use the full amount of the claim (including any amount compromised) to offset benefits in accordance with Sec. 273.17.

(iii) You may reinstate any compromised portion of a claim if the claim becomes delinquent.

(8) Terminating and writing-off claims--(i) A terminated claim is a claim in which all collection action has ceased. A written-off claim is no longer considered a receivable subject to continued Federal and State agency collection and reporting requirements.

(i) A terminated claim is a claim in which all collection action has ceased. A written-off claim is no longer considered a receivable subject to continued Federal and State agency collection and reporting requirements.

(ii) The following is our claim termination policy: ------------------------------------------------------------------------

(A) you find that the claim must discharge the it is appropriate to

is invalid. claim and reflect pursue the

the event as a overpayment as a

balance adjustment different type of

rather than a claim (e.g., as an

termination. IHE rather than an

IPV claim).(B) all adult household must terminate and you plan to pursue

members die. write-off the claim. the claim against

the estate.(C) the claim balance is $25 must terminate and other claims exist

or less and the claim has write-off the claim. against this

been delinquent for 90 days household resulting

or more. in an aggregate

claim total of

greater than $25.(D) you determine it is not must terminate and we have not approved

cost effective to pursue write-off the claim. your overall cost-

the claim any further. effectiveness

criteria.(E) the claim is delinquent must terminate and you plan to continue

for three years or more. write-off the claim. to pursue the claim

through Treasury's

Offset Program.(F) you cannot locate the may terminate and

household. write-off the claim.(G) a new collection method may reinstate a you decide not to

or a specific event (such terminated and pursue this option.

as winning the lottery) written-off claim.

substantially increases the

likelihood of further

collections.------------------------------------------------------------------------

(f) Acceptable forms of payment. ------------------------------------------------------------------------

(1) Reducing benefits prior to You must follow the

issuance. This includes allotment instructions and limits found

reduction and offsets to restored in paragraphs (g)(1) and

benefits. (g)(3) of this section.(2) Reducing benefits after issuance. You must follow the

These are benefits from electronic instructions and limits found

benefit transfer (EBT) accounts. in paragraph (g)(2) of this

section.(3) Accepting cash or any of its You do not have to accept

generally accepted equivalents. These credit or debit cards if you

equivalents include check, money do not have the capability to

order, and credit or debit cards. accept these payments.(4) Accepting paper food coupons....... You must destroy any coupons or

coupon books that are not

returned to inventory and

document as appropriate.(5) Conducting your own offsets and You must follow any limits that

intercepts. This includes but is not may apply in paragraph (g) of

limited to wage garnishments and this section.

intercepts of various State payments.

These collections are considered

``cash'' for FNS claim accounting and

reporting purposes.

(6) Requiring the household to perform This form of payment must be

public service. ordered by a court and

specifically be in lieu of

paying any claim.(7) Participating in the Treasury You must follow the procedures

collection programs. found in paragraph (n) of this

section.------------------------------------------------------------------------

(g) Collection methods--(1) Allotment reduction. The following is our allotment reduction policy: ------------------------------------------------------------------------

(i) Automatically collect payments for the claim is being collected at

any claim by reducing the amount of regular intervals at a higher

monthly benefits that a household amount or another household is

receives. already having its allotment

reduced for the same claim

(see paragraph (g)(1)(vi) of

this section).(ii) For an IPV claim, limit the amount the household agrees to a

reduced to the greater of $20 per higher amount.

month or 20 percent of the household's

monthly allotment or entitlement.(iii) For an IHE or AE claim, limit the the household agrees to a

amount reduced to the greater of $10 higher amount.

per month or 10 percent of the

household's monthly allotment.(iv) Not reduce the initial allotment the household agrees to this

when the household is first certified. reduction.(v) Not use additional involuntary the additional payment is

collection methods against individuals voluntary; or the source of

in a household that is already having the payment is irregular and

its benefit reduced. unexpected such as a State tax

refund or lottery winnings

offset.------------------------------------------------------------------------

You may . . .------------------------------------------------------------------------

(vi) Collect using allotment reduction from two separate households for

the same claim. However, you are not required to perform this

simultaneous reduction.------------------------------------------------------------------------(vii) Continue to use any other collection method against any individual

who is not a current member of the household that is undergoing

allotment reduction.------------------------------------------------------------------------

(2) Benefits from EBT accounts. (i) As a State agency, you must allow a household to pay its claim using benefits from its EBT benefit account.

(i) As a State agency, you must allow a household to pay its claim using benefits from its EBT benefit account.

(ii) You must comply with the following EBT benefit claims collection and adjustment requirements: ------------------------------------------------------------------------

------------------------------------------------------------------------

(A) For collecting from active (or reactivated) EBT benefits . . .------------------------------------------------------------------------You . . . or . . . and . . .need written permission which oral permission the retention

may be obtained in advance and for one time rules do apply to

done in accordance with reductions with this collection.

paragraph (g)(2)(iv) of this you sending the

section;. household a

receipt of the

transaction

within 10 days.------------------------------------------------------------------------

(B) For collecting from stale EBT benefits . . .------------------------------------------------------------------------You . . . and . . . and . . .

must mail or otherwise deliver give the household the retention

to the household written at least 10 days rules apply to

notification that you intend to to notify you this collection.

apply the benefits to the that it doesn't

outstanding claim. want to use these

benefits to pay

the claim.------------------------------------------------------------------------

(C) For making an adjustment with expunged EBT benefits . . .------------------------------------------------------------------------You . . . and . . . and . . .must adjust the amount of any this can be done the retention

claim by subtracting any anytime. rules do not

expunged amount from the EBT apply to this

benefit account for which you adjustment.

become aware.------------------------------------------------------------------------

(iii) A collection from an EBT account must be non-settling against the benefit drawdown account.

(iv) At a minimum, any written agreement with the household to collect a claim using active EBT benefits must include:

(A) A statement that this collection activity is strictly voluntary;

(B) The amount of the payment;

(C) The frequency of the payments (i.e., whether monthly or one time only);

(D) The length (if any) of the agreement; and

(E) A statement that the household may revoke this agreement at any time.

(3) Offsets to restored benefits. You must reduce any restored benefits owed to a household by the amount of any outstanding claim. This may be done at any time during the claim establishment and collection process.

(4) Lump sum payments. You must accept any payment for a claim whether it represents full or partial payment. The payment may be in any of the acceptable formats.

(5) Installment payments. (i) You may accept installment payments made for a claim as part of a negotiated repayment agreement.

(i) You may accept installment payments made for a claim as part of a negotiated repayment agreement.

(ii) As a household, if you fail to submit a payment in accordance with the terms of your negotiated repayment schedule, your claim becomes delinquent and it will be subject to additional collection actions.

(6) Intercept of unemployment compensation benefits. (i) As a State agency, you may arrange with a liable individual to intercept his or her unemployment compensation benefits for the collection of any claim. This collection option may be included as part of a repayment agreement.

(i) As a State agency, you may arrange with a liable individual to intercept his or her unemployment compensation benefits for the collection of any claim. This collection option may be included as part of a repayment agreement.

(ii) You may also intercept an individual's unemployment compensation benefits by obtaining a court order.

(iii) You must report any intercept of unemployment compensation benefits as ``cash'' payments when they are reported to us.

(7) Public service. If authorized by a court, the value of a claim may be paid by the household performing public service. As a State agency, you will report these amounts in accordance with our instructions.

(8) Other collection actions. You may employ any other collection actions to collect claims. These actions include, but are not limited to, referrals to collection and/or other similar private and public sector agencies, state tax refund and lottery offsets, wage garnishments, property liens and small claims court.

(9) Unspecified joint collections. When an unspecified joint collection is received for a combined public assistance/food stamp recipient claim, each program must receive its pro rata share of the amount collected. An unspecified joint collection is when funds are received in response to correspondence or a referral that contained both the food stamp and other program claim(s) and the debtor does not specify to which claim to apply the collection.

(h) Refunds for overpaid claims. (1) As a household, if you overpay a claim, the State agency must provide a refund for the overpaid amount as soon as possible after the State agency finds out about the overpayment. You will be paid by whatever method the State agency deems appropriate considering the circumstances.

(1) As a household, if you overpay a claim, the State agency must provide a refund for the overpaid amount as soon as possible after the State agency finds out about the overpayment. You will be paid by whatever method the State agency deems appropriate considering the circumstances.

(2) You are not entitled to a refund if the overpaid amount is attributed to an expunged EBT benefit.

(i) Interstate claims collection. (1) Unless a transfer occurs as outlined in paragraph (i)(2) of this section, as a State agency, you are responsible for initiating and continuing collection action on any food stamp recipient claim regardless of whether the household remains in your State.

(1) Unless a transfer occurs as outlined in paragraph (i)(2) of this section, as a State agency, you are responsible for initiating and continuing collection action on any food stamp recipient claim regardless of whether the household remains in your State.

(2) You may accept a claim from another State agency if the household with the claim moves into your State. Once you accept this responsibility, the claim is yours for future collection and reporting. You will report interstate transfers to us in accordance with our instructions.

(j) Bankruptcy. A State agency may act on our behalf in any bankruptcy proceeding against a bankrupt household with outstanding recipient claims.

(k) Retention rates. (1) The retention rates for State agencies are as follows: ------------------------------------------------------------------------

(i) IPV claim.................... 35 percent.(ii) IHE claim................... 20 percent.(iii) IHE claim by reducing a 35 percent.

person's unemployment

compensation benefit.(iv) AE claim.................... nothing.------------------------------------------------------------------------

(2) These rates do not apply to:

(i) Any reduction in benefits when you disqualify someone for an IPV;

(ii) The value of court-ordered public service performed in lieu of the payment of a claim; or

(iii) Payments made to a court that are not subsequently forwarded as payment of an established claim.

(l) Submission of payments to us. A State agency must send us the value of funds collected for IHE, IPV or AE claims according to our instructions. We must pay you for claims collection retention by electronic funds transfer.

(m) Accounting procedures. (1) As a State agency, you must maintain an accounting system for monitoring recipient claims against households. This accounting system shall consist of both the system of records maintained for individual debtors and the accounts receivable summary data maintained for these debts.

(1) As a State agency, you must maintain an accounting system for monitoring recipient claims against households. This accounting system shall consist of both the system of records maintained for individual debtors and the accounts receivable summary data maintained for these debts.

(2) At a minimum, the accounting system must document the following for each claim:

(i) The date of discovery;

(ii) The reason for the claim;

(iii) The calculation of the claim;

(iv) The date you established the claim;

(v) The methods used to collect the claim;

(vi) The amount and incidence of any claim processing charges;

(vii) The reason for the final disposition of the claim;

(viii) Any collections made on the claim;

(ix) Any correspondence, including follow-up letters, sent to the household.

(3) At a minimum, your accounting or certification system must also identify the following for each claim:

(i) Those households whose claims have become delinquent;

(ii) Those situations in which an amount not yet restored to a household can be used to offset a claim owed by the household; and

(iii) Those households with outstanding claims that are applying for benefits.

(4) When requested and at intervals determined by us, your accounting system must also produce:

(i) Accurate and supported outstanding balances and collections for established claims; and

(ii) Summary reports of the funds collected, the amount submitted to FNS, the claims established and terminated, any delinquent claims processing charges, the uncollected balance and the delinquency of the unpaid debt.

(5) On a quarterly basis, unless otherwise directed by us, your accounting system must reconcile summary balances reported to individual supporting records.

(n) Treasury's Offset Programs (TOP)--(1) Referring debts to TOP. (i) As a State agency, you must refer to TOP all recipient claims that are delinquent for 180 or more days.

(1) Referring debts to TOP. (i) As a State agency, you must refer to TOP all recipient claims that are delinquent for 180 or more days.

(i) As a State agency, you must refer to TOP all recipient claims that are delinquent for 180 or more days.

(ii) You must certify that all of these claims to be referred to TOP are 180 days delinquent and legally enforceable.

(iii) You must refer these claims in accordance with our and the Department of the Treasury's (Treasury) instructions.

(iv) You must not refer claims to TOP that:

(A) You become aware that the debtor is a member of a participating household that is having its allotment reduced to collect the claim; or

(B) Fall into any other category designated by us as non-referable to TOP.

(2) Notifying debtors of referral to TOP. (i) As a State agency, you must notify the debtor of the impending referral to TOP according to our instructions relating to:

(i) As a State agency, you must notify the debtor of the impending referral to TOP according to our instructions relating to:

(A) What constitutes an adequate address to send the notice;

(B) What specific language will be included in the TOP referral notice;

(C) What will be the appropriate time frames and appeal rights; and

(D) Any other information that we determine necessary to fulfill all due process and other legal requirements as well as to adequately inform the debtor of the impending action.

(ii) You must also follow our instructions regarding procedures connected with responding to inquiries, subsequent reviews and hearings, and any other procedures determined by us as necessary in the debtor notification process.

(3) Effect on debtors. (i) If you, as a debtor, have your claim referred to TOP, any eligible Federal payment that you are owed may be intercepted through TOP.

(i) If you, as a debtor, have your claim referred to TOP, any eligible Federal payment that you are owed may be intercepted through TOP.

(ii) You may also be responsible for paying any collection or processing fees charged by the Federal government to intercept your payment.

(4) Procedures when a claim is in TOP. (i) As a State agency, you must follow FNS and Treasury procedures when the claim is in TOP.

(i) As a State agency, you must follow FNS and Treasury procedures when the claim is in TOP.

(ii) You must remove a claim from TOP if:

(A) FNS or Treasury instruct you to remove the debt; or

(B) You discover that:

(1) The debtor is a member of a food stamp household undergoing allotment reduction;

(2) The claim is paid up;

(3) The claim is disposed of through a hearing, termination, compromise or any other means;

(4) The claim was referred to TOP in error; or

(5) You make an arrangement with the debtor to resume payments.

(5) Receiving and reporting. As a State agency, you must follow our procedures on receiving and reporting TOP payments.

(6) Security or confidentiality agreements. As a State agency, you must follow our procedures regarding any security or confidentiality agreements or processes necessary for TOP participation. [Amdt. 389, 65 FR 41775, July 6, 2000; 65 FR 47587, Aug. 2, 2000, as amended at 75 FR 78153, Dec. 15, 2010] Sec. 273.19 [Reserved]