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State of Wisconsin |
Release 24-01 |
An overpayment occurs when BadgerCare Plus benefits are paid for someone who was not eligible for them or when a member should have paid a higher amount of premiums. Effective April 1, 2023, DHS and IM agencies will no longer establish new BadgerCare Plus overpayment claims for members.
Income maintenance (IM) agencies may refer suspected fraudulent activity to the DHS Office of the Inspector General (OIG), the district attorney (DA), or corporation counsel for investigation. The DA or corporation counsel may prosecute for fraud.
| Note | This policy on member overpayment claims does not include provider overpayments where there is an error in a claims payment to a provider or repayments that are part of the Estate Recovery Program (see Chapter 33 Estate Recovery). |
This page last updated in Release Number: 23-02
Release Date: 04/17/2023
Effective Date: 04/1/2023
The information concerning the BadgerCare Plus program provided in this handbook release is published in accordance with: Titles XI, XIX and XXI of the Social Security Act; Parts 430 through 481 of Title 42 of the Code of Federal Regulations; Chapter 49 of the Wisconsin Statutes; and Chapters HA 3, DHS 2 and 101 through 109 of the Wisconsin Administrative Code.
Notice: The content within this manual is the sole responsibility of the State of Wisconsin's Department of Health Services (DHS). This site will link to sites outside of DHS where appropriate. DHS is in no way responsible for the content of sites outside of DHS.
Publication Number: P-10171