Section 80. Fraud

A. Fraud.

1. When it is suspected that there has been a deliberate misrepresentation of facts in order to receive benefits, services, or payments, the local department must determine whether or not fraud was committed. There must be clear and convincing evidence that demonstrates that the household or provider committed or intended to commit fraud. Suspected instances of child care fraud shall be referred to the fraud staff for investigation. If there is clear and convincing evidence that fraud has occurred with either the provider or the household, the case will be referred to the attorney for the Commonwealth to determine if the case will be prosecuted. If the household's case does not meet the criteria for prosecution as established by the attorney for the Commonwealth, the case will be referred for an administrative disqualification hearing.

2. Disqualification.

a. Parents will be disqualified from participating in the child care subsidy program for three months upon the first finding of child care fraud or an intentional program violation, 12 months upon the second finding, and permanently upon the third finding.

b. Providers will be permanently disqualified from participating in the child care subsidy program upon the first finding of child care fraud.

B. Repayment. In addition to any criminal punishment, anyone who causes the local department to make an improper provider payment by withholding required information or by providing false information will be required to repay the amount of the improper payment.

Historical Notes

Derived from Volume 21, Issue 19, eff. August 1, 2005; amended, Virginia Register Volume 32, Issue 07, eff. February 1, 2016.

Statutory Authority

§ 63.2-217 of the Code of Virginia; 45 CFR 98.11.