Section DHS 109.62 - Recovery of incorrect payments from participants(1) The department shall begin recovery action against any SeniorCare participant to whom or on whose behalf an incorrect payment was made resulting from any of the following: (a) A misstatement or omission of fact by the person supplying information on an application, a request for a new benefit period, or a review of eligibility for SeniorCare benefits.(b) A check submitted for the program enrollment fee is returned for non-sufficient funds under s. DHS 109.11(6) (d).(c) A recipient fails to inform the department, within 10 calendar days of the change, of changes in circumstances that affect eligibility. (d) A recipient received benefits while an appeal requested under s. DHS 109.63 was pending and the contested decision is upheld.(2) The amount of recovery may not exceed the amount of the SeniorCare benefits incorrectly provided.(3) Department records of payment for the period of ineligibility shall be evidence of the amounts paid on behalf of the participant.(4) The department shall notify the participant or the participant's representative of the period of ineligibility and the amounts incorrectly paid, and shall request arrangement of repayment within a specified period of time.(5) If the department does not recover incorrect payments under sub. (4), the department shall refer cases of possible recovery to the district attorney or corporation counsel for investigation and the district attorney or corporation counsel may bring whatever action may be appropriate for prosecution for fraud or collection under civil liability statutes. If not satisfied at the time the judgment or order for restitution is rendered, judgments obtained in these actions shall be filed as liens against property in any county in which the participant is known to possess assets. Execution may be taken on the judgments as otherwise provided in statute.(6) The department may seek recovery through an order for restitution by the court of jurisdiction in which the participant or former participant is being prosecuted for fraud.Wis. Admin. Code Department of Health Services DHS 109.62
CR 02-154: cr. Register April 2003 No. 568, eff. 5-1-03.