Fund recoveries for debts arising from fraud, abuse, or invalid claims for reimbursement are what we collectively call over claims. An overclaim does include restoring misused funds to the nonprofit food service account and issuing any improperly withheld funds to sponsored centers and day care homes.
Overclaims that result from a Program review are from the following general categories:
- Meal overclaims. This includes failure to meet meal pattern requirements (including deductions for milk), inflated meal count claims, and claiming unapproved meal types.
- Eligibility determination overclaims resulting from errors in the classifying and claiming of Program participants.
- Facility participation overclaims. These overclaims result from sponsors claiming facilities that are not eligible, two sponsors claiming the same facility; or a sponsor claiming a facility before the State Agency approval date for the facility’s participation.
- Facility payment error overclaims including disbursing funds to ineligible facilities and disbursing the incorrect amount of money to a facility; and
- Cost overclaims. These claims include misuse of nonprofit food service account funds and unallowable administrative cost claims for home sponsors.
This information should provide institutions with some clarity concerning overclaims mentioned in review letters that result in amended claims.