R986-100-117. Disqualification Periods And Civil Penalties For Intentional Program Violations (IPVs)

  (1) An Intentional Program Violation (IPV) occurs when a person, either personally or through a representative, intentionally, knowingly, or recklessly (as those terms are defined in Utah Code Ann. Section 76-2-103 and as shown by clear and convincing evidence) violates a program rule, or helps another person violate a program rule, in an attempt to obtain, maintain, increase, or prevent the decrease or termination of public assistance payment(s) from any of the programs listed in R986-100-102. Acts which may constitute an IPV include but are not limited to:

  (a) making false or misleading statements;

  (b) misrepresenting, concealing, or withholding facts or information;

  (c) posing as someone else;

  (d) taking, using or accepting a public assistance payment the person knew they were not eligible to receive or not reporting the receipt of a public assistance payment the person knew they were not eligible to receive;

  (e) not reporting a material change as required by and in accordance with these rules;

  (f) committing an act intended to mislead, misrepresent, conceal or withhold facts or propound a falsity;

  (g) accessing TANF financial assistance benefits through an electronic benefit transfer, including through an automated teller machine or point-of-sale device, in an establishment in the state that:

  (i) exclusively or primarily sells intoxicating liquor,

  (ii) allows gambling or gaming, or

  (iii) provides adult-oriented entertainment where performers disrobe or perform unclothed;

  (h) using TANF financial assistance benefits to purchase beer, intoxicating beverages, cigarettes, or tobacco; or

  (i) committing any act that constitutes a violation of federal or state law for the purpose of using, presenting, transferring, acquiring, receiving, possessing, or trafficking SNAP or EBT cards.

  (2) When an IPV is alleged, the Department may:

  (a) Refer the case for criminal prosecution;

  (b) In SNAP cases, refer the case for an administrative disqualification hearing (ADH); or

  (c) In non-SNAP cases, issue an initial decision finding the person committed an IPV, which the person may appeal via the fair hearing process set forth in R986-100-123 to -135.

  (3) The Department may not disqualify a person from SNAP unless an ADH has been held or the person has been criminally convicted. The Department may not make concurrent referrals for an ADH and criminal prosecution. If a SNAP case referred for criminal prosecution is dismissed or referred back to the Department without prosecution, the Department may refer the case for an ADH.

  (4) A person who is found liable for committing an IPV in either an administrative or criminal proceeding shall:

  (a) In the case of any program other than SNAP, be assessed a civil penalty of 10% of the amount of the overpayment; and

  (b) In the case of any program other than Medicaid, be disqualified from receiving assistance from the program(s) at issue for a period of:

  (i) 12 months for a first offense;

  (ii) 24 months for a second offense; and

  (iii) Permanently for a third offense.

  (c) Disqualifications run concurrently.

  (d) A disqualification applies only to the person(s) found to have committed an IPV. However, all adult members of the relevant household at the time the overpayment occurred shall be responsible for repaying the overpayment.

  (e) Notwithstanding the foregoing, if a more specific provision of federal or state law provides for different sanctions for committing an act that constitutes an IPV, that provision is controlling.

  (5) All income and assets of a person who has been disqualified from assistance for an IPV continue to be counted and affect the eligibility and assistance amount of the household assistance unit in which the person resides.

  (6) If an individual has been disqualified in another state, the disqualification period for the IPV in that state will apply in Utah provided the act which resulted in the disqualification would have resulted in a disqualification had it occurred in Utah. If the individual has been disqualified in another state for an act which would have led to disqualification had it occurred in Utah and is found to have committed an IPV in Utah, the prior periods of disqualification in any other state count toward determining the length of disqualification in Utah.

  (7) The person being disqualified will be notified that a disqualification period has been determined. The disqualification period shall begin no later than the second month which follows the date the person being disqualified receives written notice of the disqualification and continues in consecutive months until the disqualification period has expired. The Department will also provide written notice to any remaining household members informing them of the allotment they will receive during the disqualification period.

  (8) Nothing in these rules is intended to limit or prevent a criminal prosecution for fraud based on the same facts used to determine the IPV.