45 C.F.R. § 235.110
Fraud
State plan requirements: A State plan under title I, IV-A, X, XIV, or XVI of the Social Security Act must provide:
(a) That the State agency will establish and maintain:
(1) Methods and criteria for identifying situations in which a question of fraud in the program may exist, and
(2) Procedures developed in cooperation with the State's legal authorities for referring to law enforcement officials situations in which there is valid reason to suspect that fraud has been practiced.
(b) For methods of investigation of situations which there is a question of fraud, that do not infringe on the legal rights of persons involved and are consistent with the principles recognized as affording due process of law.
(c) For the designation of official position(s) responsible for referral of situations involving suspected fraud to the proper authorities.
Notes of Decisions
Cited in 13
cases, 1972–1990 · leading case: 15,844 Welfare Recipients v. King, 474 F. Supp. 1374 (D. Mass. 1979).
15,844 Welfare Recipients v. King, 474 F. Supp. 1374 (D. Mass. 1979). “110 (a) to (1) publish methods and criteria for identifying fraud prior to making fraud referrals; (2) to provide advance written notice of a recipient’s rights to counsel and to remain silent and of the possible criminal consequences of his cooperation during the interview; (3)…”
Fifteen Thousand Eight Hundred & Forty-Four Welfare Recipients v. Edward J. King, 610 F.2d 32 (1st Cir. 1979). “Specifically, appellants claim that the various procedures adopted by the state for referring possible cases of fraud from the DPW to the BWA and from the BWA to law enforcement officials violate an HEW regulation, 45 C.F.R. § 235.110 , which requires that a state plan…”
Commonwealth v. Morris, 575 A.2d 582 (Pa. 1990). “45 CFR § 235.110 . In Commonwealth v. Ferguson, supra , this author explained: Pennsylvania has a paramount interest in seeing that its limited public assistance funds are distributed as provided by law.”
Carleson v. Superior Court, 27 Cal. App. 3d 1 (Cal. Ct. App. 1972). “6 In response to the Director’s argument that authority for the System is found in 45 C.F.R. § 235.110 (a)(1), which requires the DSW to establish and maintain “[mjethods and criteria' for identifying situations in which a question of fraud in the [AFDC] program may exist,” the…”
Rush v. Smith, 573 F.2d 110 (2d Cir. 1978). “Pursuant to § 1302, the Act’s general authorization for agency rulemaking, the Secretary has adopted 45 C.F.R. § 235.110 , entitled “Fraud.” This requires that the State plan provide: (a) That the State agency will establish and maintain: (1) Methods and criteria for identifying…”
United States v. McDaniels, 370 F. Supp. 293 (E.D. La. 1973). “45 C.F.R. § 235.110 (c). ' 5 . 45 C.F.R. § 206.”
Alice Roberts v. Edward T. Austin, Individually & in His Off. Capacity as State Attorney, Fourth Jud. Circuit, State of Florida, 632 F.2d 1202 (4th Cir. 1980). “It is also worth noting that 45 C.F.R. § 235.110 , the Health and Human Resources equivalent of Agriculture’s 7 C.”
Owens v. Roberts, 377 F. Supp. 45 (M.D. Fla. 1974). “When fraud is suspected, the state is guided by the standards of subsection (b) of 45 C.F.R. § 235.110 (1972) which states that state plans must provide “for methods of investigation in which there is a question of fraud, that do not infringe on the legal rights of persons…”
Rush v. Smith, 437 F. Supp. 576 (S.D.N.Y. 1977). “2, and 45 C.F.R. § 235.110 . Plaintiffs do not dispute that defendants are required to investigate and prosecute fraud.”
Deel v. Jackson, 862 F.2d 1079 (4th Cir. 1988). “See 45 C.F.R. § 235.110 (1986). Congress’ receptivity to transfer of assets rules themselves can be seen from the fact *1085 that it has specifically endorsed such a rule in the context of the Medicaid program.”
Deel v. Lukhard, 830 F.2d 1283 (4th Cir. 1987). “See 45 C.F.R. § 235.110 (1986). However, in view of our determination that the transfer of assets rule is invalid because it conflicts with the availability principle of federal law, we must conclude that the rule cannot be upheld as a valid fraud-control device.”
Jackson v. O'Bannon, 633 F.2d 329 (3rd Cir. 1980). “We believe intentional duplicate payments represent an unwarranted diversion of the program’s funds similar to that which occurs in instances of fraud and that the Social Security Act should not be construed to oblige participating states to make such payments.”
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