OAR 461-195-0541
Liability for Overpayments
(1)
In all programs except the HSD medical, OSIP, OSIPM, QMB, REFM, and SNAP programs or a child care program, the following persons are liable for repayment of an overpayment (see OAR 461-195-0501 (Definitions and Categories of Overpayments)):(a)
Each individual in the filing group or required to be in the filing group and the payee when the overpayment was incurred, except an individual who did not reside with and did not know they were included in the filing group.(b)
A caretaker relative (see OAR 461-001-0000 (Definitions for Chapter 461)) and their spouse (see OAR 461-001-0000 (Definitions for Chapter 461)) who were not part of, but resided with, the filing group when the overpayment was incurred.(c)
A parent (see OAR 461-001-0000 (Definitions for Chapter 461)) or caretaker relative of a child (see OAR 461-001-0000 (Definitions for Chapter 461)) in the benefit group (see OAR 461-110-0750 (Benefit Group)) and the spouse of the parent or caretaker relative if the parent, caretaker relative, or spouse was a member of or resided with the filing group when the overpayment was incurred.(d)
An individual determined liable for an overpayment remains liable when the individual becomes a member of a new filing group.(e)
An authorized representative (see OAR 461-115-0090 (Authorized Representatives; General)) when the authorized representative knowingly gave incorrect or incomplete information or intentionally withheld information resulting in the overpayment.(2)
In the HSD medical and REFM programs, the following persons are liable for repayment of an overpayment:(a)
Each individual in the filing group, the HSD medical programs eligibility determination group (see OAR 410-200-0015 (General Definitions)), or required to be in the filing group and the payee when the overpayment was incurred, except an individual who ---(A)
Was a child or dependent child (see OAR 461-001-0000 (Definitions for Chapter 461)) at the time of the overpayment; or(B)
Did not reside with and did not know they were included in the filing group.(b)
A caretaker relative and their spouse who were not part of, but resided with, the filing group or HSD medical programs eligibility determination group when the overpayment was incurred.(c)
A parent or caretaker relative of a child in the filing group or HSD medical programs eligibility determination group and the spouse of the parent or caretaker relative if the parent, caretaker relative, or spouse was a member of or resided with the filing group or HSD medical programs eligibility determination group when the overpayment was incurred.(d)
An authorized representative (see OAR 461-115-0090 (Authorized Representatives; General) and OAR 410-200-0015 (General Definitions)) when the authorized representative knowingly gave incorrect or incomplete information or intentionally withheld information that resulted in the overpayment.(3)
In a child care program:(a)
An overpayment caused by administrative error is collectible as follows:(A)
The provider is liable for a provider overpayment made on behalf of a client eligible for child care payments.(B)
Each adult in the filing group or required to be in the filing group is liable for an overpayment if the client was not eligible for the payment.(b)
Each adult in the filing group or required to be in the filing group is liable for a client overpayment, and a provider is liable for an overpayment caused by the provider. The client and provider are jointly and severally liable for an overpayment caused by both. In the case of an alleged provider overpayment, a provider’s failure to provide contemporaneous records of care provided creates a rebuttable presumption that the care was not provided.(c)
An adult who cosigned an application with a minor provider applicant is liable for an overpayment incurred by the minor provider.(d)
An authorized representative (see OAR 461-115-0090 (Authorized Representatives; General)) is liable for an overpayment when the authorized representative knowingly gave incorrect or incomplete information or intentionally withheld information that resulted in the overpayment.(4)
In the GA, OSIP, OSIPM, and QMB programs, the following persons are liable for repayment of an overpayment:(a)
Each individual in the filing group or required to be in the filing group and the payee when the overpayment was incurred, except an individual who ---(A)
Was a child or dependent child at the time of the overpayment; or(B)
Did not reside with and did not know they were included in the filing group.(b)
A caretaker relative and their spouse who were not part of, but resided with, the filing group when the overpayment was incurred.(c)
A parent or caretaker relative of a child in the filing group and the spouse of the parent or caretaker relative if the parent, caretaker relative, or spouse was a member of or resided with the filing group when the overpayment was incurred.(d)
An authorized representative when the authorized representative knowingly gave incorrect or incomplete information or intentionally withheld information that resulted in the overpayment.(5)
In the SNAP program, the following persons are liable for repayment of an overpayment or a claim that results from trafficking (see OAR 461-195-0601 (Intentional Program Violations; Defined)(2)) of SNAP benefits:(a)
The primary person (see OAR 461-001-0015 (Definitions; SNAP)) of any age, an ineligible student in the household, and all adults (see OAR 461-001-0015 (Definitions; SNAP)) who were members of or required to be in the filing group (see OAR 461-110-0370 (Filing Group; SNAP)) when excess benefits were issued.(b)
A sponsor of a non-citizen household member if the sponsor is at fault, for payments prior to November 21, 2000.(c)
A drug or alcohol treatment center or residential care facility that acted as the authorized representative of the client.(d)
An authorized representative when the authorized representative knowingly gave incorrect or incomplete information or intentionally withheld information that resulted in the overpayment.(e)
For a claim that results in trafficking, the payee and the authorized representative when they actually traffic the benefits.(6)
Except as provided otherwise in section (7) of this rule, in all programs, both a non-citizen and the sponsor of the non-citizen are liable for an overpayment incurred if the overpayment results from the failure of the sponsor to provide correct information (see OAR 461-145-0820 (Deemed Assets; Noncitizen’s Sponsor) to 461-145-0840). If the sponsor had good cause (see OAR 461-195-0521 (Calculation of Overpayments)(5)) for withholding the information, the sponsor is not liable for the overpayment.(7)
In the SNAP program, the sponsor of a non-citizen is not liable under section (6) of this rule for payments on or after November 21, 2000.(8)
In the HSD medical programs, the November 2013 amendments to OAR 461-195-0501 (Definitions and Categories of Overpayments), 461-195-0521 (Calculation of Overpayments), 461-195-0541 (Liability for Overpayments), and 461-195-0561 (Compromise of an Overpayment Claim) apply as of October 1, 2013.
Source:
Rule 461-195-0541 — Liability for Overpayments, https://secure.sos.state.or.us/oard/view.action?ruleNumber=461-195-0541.