Late Claims and Adjustments Memo (Policy Clarification)
651/582-8526 800/366-8922
FOOD AND NUTRITION SERVICE
MEMORANDUM
DATE: March 22, 2002
|
TO: SPONSORING AUTHORITIES of School Nutrition Programs Child and Adult Care Food Program Summer Food Service Program Milk-Only Programs |
FROM: Mary Begalle, Director Food and Nutrition Service |
SUBJECT: Late Claims and Adjustments
Summary
This memorandum restates and clarifies the "60/90 day" rules established by the U.S. Department of Agriculture (USDA) for submission of child nutrition program claims in a timely manner. Limited situations are described in which a claim submitted after 60 days or an adjusted claim submitted after 90 days will be accepted.
Timelines for Submission of Claims
General Rule - Federal regulations for child nutrition programs require sponsors to:
• Submit a claim within 60 calendar days of the claiming month.
• Submit any adjustment to a claim (that has been submitted within the 60 calendar day timeline) within 90 calendar days of the claiming month.
Exceptions - Federal regulations provide for exceptions to the 60/90-day claiming periods in limited situations as described.
Downward Claim Adjustments
The 90-day time limit does not apply to downward adjustments. Federal regulations require that downward adjustments shall be made regardless of when it is determined that adjustments are necessary.
Circumstances Outside of Sponsor Control
If the original or adjusted claim is late due to circumstances outside of the sponsor’s control, the sponsor may request an exception to the 60 or 90-day limit. Examples of circumstances outside of the sponsor’s control include flood, fire, natural disasters, etc.
Circumstances Within Sponsor Control
If the claim is late due to circumstances within the sponsor's control, the sponsor may request an exception to the 60 or 90-day limit unless this exception has already been requested for the affected program/s within the previous 36 months. Examples of circumstances within the sponsor’s control are personnel changes, lack of training for personnel, time needed to gather/process information, lost information, etc.
Limitations on exceptions for circumstances within sponsor control:
• May be granted to a sponsor only once within a 36-month period for any given federal program - NSLP, SBP, CACFP, SFSP or SMP.
• May be granted only for one monthly claim.
More Ú
Review or Audit Findings
FNS may grant an exception for late upward adjustments that result from a review or audit. To request this type of exception, the sponsor must submit information to FNS as described in the Required Actions section of this memorandum.
Appeals - A sponsor may submit a written appeal to FNS regarding a claim or adjustment that has been denied due to 60 or 90-day submission deadlines.
Background
Federal regulations regarding claiming reimbursement can be found in the federal regulations for each program, at www.fns.usda.gov/cnd/.
• National School Lunch Program regulations - refer to 7 CFR 210.8 (5)(b)(1).
• Child and Adult Care Food Program regulations - refer to 7 CFR 226.10 (4)(e).
• Summer Food Service Program regulations - refer to 7 CFR 225.9 (d)(6).
• Special Milk Program regulations - refer to 7 CFR 215.10 (b).
For 60 and 90-day dates for each claiming month, refer to "2001-02 Claim Reimbursement Due Dates." This document is available on the FNS web page at https://fns.state.mn.us - select "FNS Nutrition Programs," then select your child nutrition program, then select "Resources."
Required Actions for Late Claims and Adjustments
• To submit a downward adjustment: Send revised claims to FNS at any time.
• To submit an original claim after 60 calendar days, or upward adjustments after 90 days, that is late due to circumstances outside of sponsor's control:
Request an exception from FNS by submitting a written description of the outside events and circumstances that prevented the claims from being submitted on time.
• To submit one original claim after 60 days, or one upward adjustment after 90 days, that is late due to circumstances within the sponsor's control (this exception available only if sponsor has not already used this type of exception, for the program/s claimed, within the previous 36 months):
Request an exception from FNS by submitting signed documentation, including an outline of the procedures/actions taken by sponsor to avoid repetition of the situation that caused the error in claiming.
Before requesting this exception, sponsor should evaluate whether the late claim or adjustment is large enough, in relation to sponsor's usual total claim, to justify "using up" the exception for the affected program or programs for the next 36 months, or whether the exception should be "saved" for possible use during the following 36 months.
• To submit late adjustments resulting from FNS review findings or from audit findings:
a. If the adjustment resulted from an FNS review, FNS review staff will initiate the required claim adjustments;
b. If the adjustment resulted from an audit, submit:
1. Letter from auditor, or copy of audit finding, specifying the necessary adjustment(s);
2. Signed documentation of the procedures/actions taken by sponsor to avoid repetition of the situation that caused the error.
Procedures applicable to requests for all types of exceptions:
• Submit documents to FNS by faxing to 651/582-8501 or mailing to 1500 Highway 36 West, Roseville, MN 55113-4266.
• Include copies of claim forms with all information entered for each site and signature. To obtain the claim form, print a blank claim from the CLiCS claim screens for each site.
• FNS will review the submitted information. If the exception is approved, claim(s) will be entered into the CLiCS system by FNS staff for payment processing. If the exception is denied, formal correspondence will be sent to the sponsoring authority.
Questions regarding this information should be directed to FNS at 651/582-8526 or 800/366-8922 or e-mail to fns@state.mn.us.
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