The following procedures will be completed for reports of suspected fraud that warrant criminal prosecution:

1. (1)

   1. (A) The case record and any other pertinent information concerning the suspected participant will be requested from the local office manager.
   2. (B) Department of Human Services offices, sections, and units must release any requested information to the Fraud Investigation Unit of the Office of Security and Compliance of the Department of Human Services; and

2. (2) The investigator assigned to the case will:

   1. (A) Examine the case record and/or any other records on file within or outside the Department of Human Services for suspected false statements of:

      1. (i) Participants;
      2. (ii) Providers; or
      3. (iii) Other persons;
   2. (B) Conduct a systematic inquiry to determine validity of allegations of criminal conduct and interview Program Eligibility Specialists with knowledge of the case, as well as providers, division staff, and the suspect for any accounts of alleged conduct;
   3. (C) Determine the net amount of the overpayment within the criminal statute of limitations or within time frames set out in overpayment policy for cases referred for an administrative disqualification hearing;
   4. (D) Examine the transitional employment assistance (TEA) profile of the participant to determine applicable overpayment;
   5. (E) Prepare a written, documented report at the completion of the investigation for referral to the prosecutor;
   6. (F) Complete the DHS-1208, Hearing Statement, for referral for an administrative disqualification hearing;
   7. (G) Administratively close the investigation if, at any stage of the inquiry, the investigative staff determines that the case is not suitable for prosecution or for referral for an administrative disqualification hearing; and
   8. (H) Notify the Department of Human Services referral source of the disposition of the investigation and return copies of the case record to the appropriate county or local office.