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Special Investigations Advisory Committee
December 9, 2003
DMA Building
Raleigh, NC
Shelia Dorsett called the meeting to order in place of Paul Burge who was unable to attend. The November minutes were approved with no corrections or additions.
Debbie Knowles, DSS, reported the vacant position has been posted and closed with hopes it will be filled soon. She reminded everyone of upcoming tax season and to look over your Claims Exemption Report FRD-452 (TOP) and FRD-429 (DOR) and make changes for those that should not be on exempt list. A terminal message was sent regarding information on the Date of Discovery Field that been added in EPICS that will go into effect 12-15-03. If anyone has any questions, please call DSS Automation at (919) 733-8938.
Marilyn Carpenter, USDA, reported that 13 stores have been disqualified since October. Any new referrals need to be reported to new investigator, Calvin Bullock.
Shara Britt, DMA, reported Gary Douglas in Alamance County was the top collector in Medicaid for the month of November. Gary performs all investigations in this county. Congratulations to Gary. The year-to-date collections for Medicaid were $742,911.48.
There were questions raised concerning FRR reports. There were concerns that some caseworkers were not working these reports timely and that caseworkers need training by Representatives on what to do with the FRR reports. Also, issues were raised on how much information on the FRR can be disclosed (if any) to the individual. Shara Britt will try to find answers to these questions.
Diane Daniel gave the Planning Committee Report. She stated that registration packets will be mailed mid-January. Registration will be $75.00 and $70.00 for early registration. Daily registration will be $35.00 and banquet only will be $35.00. The dates for the conference will be April 27-30, 2004. She announced the theme for this years conference is: Welfare Fraud: Taming the Beast…. A Fraudulent Adventure. The winner was Melissa Griffin of Montgomery County and a $25 prize check was presented to her by Shelia Dorsett.
Sub-committee reports were given.
Sherry
Arnold gave the report from the Day Care Committee. She informed
everyone that Lee County received a ruling on their Child Care case.
The judge's decision was that the state's decision to require the
County to immediately repay the State the amount of $39,198.00
representing disallowed costs resulting from daycare provider fraud was
in error. Since N.C.G.S 110-108 was in effect during the period of the
overpayment, which allowed the County to retain all sums collected when
they pursued fraud cases, the county will not be required to repay any
state funds. Federal regulations regarding Federal funds would override
any conflict with the state law in effect. The State has never
determined how much should be repaid to the Federal government and has
asked for clarification from the Federal government. The State should
not recover any funds from the county that are not actually required to be
repaid
to the Federal government. It was also ordered that the State bears the
responsibility of the continued fraud after the county's first request
to terminate their contract with the child care provider was denied by
the State. This totaled $11,263.33 to be subtracted from the $38,791.03
giving a new figure of $27,527.70. The state must then subtract the
portion that is State funds and any Federal monies not required to be
repaid to the Federal government.
Sherry Arnold explained the question Lee County is asking is: Does the Federal
government actually require repayment (as this is not an improper payment
under Federal definition) and if so how much? Sherry informed everyone that
the state statute was
repealed in October 2002, and new policy was written which indicates the
money must be repaid to the state at the time the fraud is determined.
As long as the counties administer the child care programs, they must
abide by their policies, which is to repay any overpayment at the time it
was
discovered. The State contends that they require the money back as the
Federal government requires they pay them back up front, however, we
have seen nothing in federal regulations that indicate all overpayments
must be paid back to the Federal Government. Sherry explained that the
Day Care Committee has spoken with someone from UCOWF who stated, their
respond from the Feds has been, “The states wanted block grants with no
strings attached and that is what we got, so if there is a problem with
program integrity, deal with it within your own state.” SIAC Day Care
Committee plans to draft a letter for SIAC's, NCSSA and the Director's
Association's approval, which would be sent to the DHHS appropriations
sub-committee within congress. This letter would express concerns the
counties have as well as the effects this is having on the State as a
whole.
Robbie Brady reported for the Increased Collections sub-committee. She brought up discussions on closing out old cases that you can't collect on and developing a form to with a check list of steps to follow for closing out an old case.
Each committee is continuing to work hard to accomplish the goals set.
The next meeting will be Tuesday, January 6, 2004 at Wake Commons Building
Meeting was adjourned.
Respectfully submitted by:
Melissa Griffin
