Program Integrity Frequently Asked Questions (FAQ) Q: What is fraud? A: Fraud is wrongful or criminal deception intended to result in financial or personal gain. For Wisconsin Shares and YoungStar, it is when someone intentionally misleads, withholds, or falsifies information to maximize a benefit or for monetary (cash) value. Q: Why does the BPI (or the Department) investigate? A: The BPI will monitor systems, records, and documents to ensure that the program policies are being followed by all stakeholders (families, providers, and by the local agencies and departments). The BPI will also investigate any concerns were it appears the policy or rules were not followed. Q: What does it mean if I am issued an overpayment? A: If you are issued an overpayment, the department provided too much subsidy. This overpayment may have been caused by an agency or client error. All overpayments must be paid back to the State of Wisconsin Department of Children and Families. Q: What if I don’t agree with the result of the investigation? A: If the person/provider being investigated does not agree with the enforcement issued by the Department, they have the right to appeal the decision within the timeframe indicated in your overpayment letter, and appear before an Administrative Law Judge to review the case. At that time the evidence and argument for both the department and the client/provider will be presented. The ALJ will then make their final decision on the case. Q: If I am investigated does that mean I will be suspended from the Wisconsin Shares Program? A: Suspension from the Wisconsin Shares Program is one of the penalties that can result from an investigation and occurs if you have been assessed an intentional program violation. Q: Why did I receive notice of overpayment? A: The notice of overpayment is a written notification to inform you that you have an overpayment given to you by the Department. An overpayment is money that must be paid back to the state. It is issued after an investigation has determined that an individual has received more funds than they were eligible to receive. Both clients and providers may be issued overpayments for violation of the Wisconsin Shares regulations. Q: What is a repayment agreement? A: A repayment agreement allows a person to schedule a payment plan by indicating what he/she will pay monthly towards their overpayment balance. The responsible party can contact the Public Assistance Collection Unit (PACU) for questions about the repayment agreement. Q: What is PACU? A: PACU is the Public Assistance Collections Unit who supports program integrity activities by collecting overpayments. Payees (clients or providers) can set up e-Payments using a checking account to schedule a payment plan, referred to as a repayment agreement. This person will be responsible for making payments toward their overpayment; delinquency of payment will result in the debt going to the collection process. Contacting PACU: Mailing Address: P.O. Box 8938 Madison, WI 53708-8938 Phone Numbers: Toll Free: 1-800-943-9499 Fax: (608) 266-8302 Email: email@example.com PACU Web Page Q: What if I don’t follow my repayment agreement that I set up? A: Failure to maintain payment arrangements will result in delinquency. Any delinquent debts may be satisfied by tax intercept and/or lien and levy initiated by the State of Wisconsin. Q: What is an IPV? A: An IPV is defined as an Intentional Program Violation. Investigation findings may indicate a client and/or a provider was found as intentionally not adhering to Wisconsin Shares rules and regulations. Examples of nonadherence include purposely not following the rules, submitting false documents, and/or misinforming the Department in order to maximize their benefits. Q: What are the IPV levels of enforcement? A: An intentional violation results in a loss of benefits. If a client continues to violate the rules the consequence will continue to increase in severity. The first violation will result in a loss of subsidy for 6 months, the second violation will result in a loss of subsidy for 12 months, and the third/final violation will result in a permanent suspension from receiving a Shares subsidy. Q: What if I disagree with the child care agency's decision about the overpayment? A: If you disagree with the agency’s issued enforcement, you have the right to request a fair hearing. A fair hearing will allow you a chance to state why you feel there has been a wrong decision about your child care eligibility and authorization. All fair hearings must be submitted within 45 days from the date listed on your overpayment notice. You may also send a written request for a fair hearing to: Division of Hearing and Appeals P.O. Box 7875 Madison, WI 53707-7875 Or, fax it to 1-608-264-9885. Q: What if I do not report changes timely? A: If the change affects the subsidy amount and your child care eligibility, you may be assessed an overpayment. Q: What if I reported changes timely, but the agency did not process my request? A: If you reported a timely change that requires a change in your subsidy and you have not received notice regarding the change you are encouraged to call your local agency. It is likely that the verification was not received or processed, or was not sufficient. The change will pend until the worker has what they need to confirm the change you have requested. You can check the status of your requested change in your parent portal or your ACCESS account. Parents can hand deliver, fax, or mail these documents to their local agency.