SECTION 730.2003. Determination and Disposition of Intentional Program Violations

(a) The Texas Department of Protective and Regulatory Services (PRS) determines the existence of intentional program violations; refers cases for investigation, administrative hearings, and prosecution; takes collection action, and ensures clients' rights according to applicable Texas criminal statutes and the following:

(1) Aid to Families with Dependent Children (AFDC) Program--45 Code of Federal Regulations §§233.20(a)(13)(B), 235.110, 235. 112, and 235.113;

(2) Food Stamp Program--7 Code of Federal Regulations §§273.16-273.18;

(3) Medicaid Program--42 Code of Federal Regulations §455.2 and 455.16.

(b) Individuals found to have committed an intentional program violation in the food stamp and/or AFDC programs either through an administrative disqualification hearing or by a court of appropriate jurisdiction, or who have signed a waiver of right to an administrative disqualification hearing, or on the basis of a plea of guilty or nolo contendere or otherwise in cases referred for prosecution in a state or federal court are ineligible to participate in the program for six months for the first violation, 12 months for the second violation, and permanently for the third violation. In AFDC cases, PRS does not take the needs of the disqualified individual into account during the period he is disqualified when determining the assistance unit's need and amount of assistance. PRS considers any resources and income of the disqualified individual as available to the assistance unit. PRS does not disqualify an individual from the AFDC program unless the overissuance of benefits resulting from the intentional violation occurred in the month of October 1988 or later.

(c) Disqualified individuals are ineligible for AFDC Medicaid benefits during the disqualification period. However, they may qualify for and receive benefits under provisions of Texas Administrative Code, Title 40, Part I, Chapter 2 (relating to the Medically Needy Program) or under provisions of Texas Administrative cidem Title 40, Part I, Chapter 4 (relating to the Medical Programs for Children and Pregnant Women).

(d) A household member may be charged with an intentional program violation even if he has not actually received benefits to which he is not entitled.

(e) The amount of the intentional program violation claim must be calculated back to the month the act of intentional program violation occurred, regardless of the length of time that elapsed until the determination of intentional program violation was made. However, PRS must not include in its calculation any amount of the overissuance which occurred in a month more than six years from the date the overissuance was discovered for food stamp cases.

Source Note: The provisions of this §730.2003 adopted to be effective January 1, 1976; amended to be effective December 28, 1976, 1 TexReg 3515; amended to be effective June 15, 1987, 12 TexReg 1394; amended to be effective July 1, 1992, 17 TexReg 3477; duplicated effective September 1, 1992, as published in the Texas Register September 11, 1992, 17 TexReg 6279.