Effective Dates: 12/06/2024 - Present Previous | Next

TN 58 (12-24)

GN 03920.052 Pursuing Recovery of Excess Fees Paid to Representatives or Entities and Referrals for Ineligible for Direct Payment Entity (IDPE) List

CITATIONS:

20 CFR 404.1703, 404.1720, 404.1730, 404.1735, 416.1503, 416.1520, 416.1530, and 416.1535

A. Introduction

We use a different process to recover excess fee payments from representatives than we use to recover excess fee payments from entities.

Recovery of excess fees paid to a representative is performed directly by the field office (FO) or processing center (PC) that identifies the issue, following the instructions in GN 03920.052B. If the representative fails to remit the excess fee, the representative may be subject to referral to the Office of General Counsel (OGC) for possible sanctions, as explained in GN 03970.017.

Recovery of excess fees paid to an entity is first attempted by the FO or PC technician who identifies the issue. However, if the entity fails to remit the excess fee, the respective FO or PC will refer the issue to the IDPE Coordinator Group as explained in GN 03920.052C.6. in this section. The IDPE Coordinator group is comprised of designated staff from each PC and Regional Office with experience in processing representative fees, and they maintain a list of Ineligible for Direct Payment Entities (IDPE). Once an entity is placed on the IDPE list, we will not issue direct fee payments to the entity until the entity resolves all outstanding issues affecting eligibility.

Entities are required to name a registered representative as their Point of Contact (POC) to help us resolve any fee-related matters that may arise. We will work with these entity POCs to resolve any fee-related matters and, if necessary, pursue recovery of excess fees from the entity. For additional information on the roles and responsibilities of POCs, see GN 03920.021D.

B. Pursuing recovery of excess fee payments made to representatives

When a technician identifies an excess fee payment made to a representative, follow these steps:

1. Confirm the excess fee meets the conditions for pursuing recovery from a representative

When a technician identifies a potential excess fee issue, the technician must first ensure that the excess fee is one for which we will pursue recovery and that the excess fee was paid to the representative.

For more information on the circumstances under which we will pursue recovery of an excess fee, see GN 03920.051B.

2. Document the situation

If the excess fee issue meets the criteria for pursuing recovery and the fee in question was paid to a representative, the technician will document the situation in a Report of contact (ROC) in the Registration, Appointment and Services for Representatives (RASR) report of contact screen.

The ROC should include the following information:

  • •

    The representative(s) involved (identify representative(s) and date(s) of appointment);

  • •

    The fee process involved (fee petition or fee agreement);

  • •

    The past-due benefit period and amount (include amounts for claimant and any affected auxiliaries);

  • •

    The date of fee authorization (for fee agreements use date of fee setting notice);

  • •

    The date fee authorization was amended or reversed by decision maker or person with fee setting authority, if applicable;

  • •

    An explanation of the incorrect fee payment, including the amount; and

  • •

    An indication of whether we correctly paid the claimant and any affected auxiliaries.

3. Verify that the claimant and representative have been notified of the correct authorized fee

Before requesting a refund of an incorrect fee payment, verify that the decision maker or person with fee setting authority sent the correct fee authorization or rescission notice. We must notify both the claimant and the representative of the correct fee.

For information on the proper authorities for authorizing fees or reviewing requests for administrative review, see

GN 03930.015 and GN 03950.005 fee petition, and

GN 03940.002 and GN 03960.015 fee agreements.

If the excess fee resulted from a reduction in the fee we authorized, ensure that notice of the revised fee action was sent to the claimant and representative.

For a fee petition case, the decision maker will have issued a corrected or revised fee authorization notice.

For a fee agreement case, the processing center (PC) (for Title II claims) or field office (FO) (for Title XVI claims) will have sent notice of the revised fee amount which includes the fee authorization language specified in GN 03940.008B.

4. Issue a refund to the claimant, if necessary

If the relevant instructions in GN 03920.051B direct us to issue a refund to the claimant, the technician will refund any erroneously withheld benefits to the claimant.

For information on refunding the excess fee withholding, see

SM 01901.005 and SM 01901.015 for Title XVI claims, and

SM 00848.330 for Title II claims.

NOTE: The claimant is not due a refund if we did not withhold past-due benefits for the fee payment. Also, the claimant may not be due a refund if the revised past-due benefits and fee resulted in an overpayment to the claimant.

5. Issue any required notices

Notify the representative of the amount they must refund to us within 30 days. For sample language, see GN 03970.025.

6. Establish the excess fee in the appropriate systems

Technicians annotate the incorrect fee payment or debt owed to us in the Debt Management System (DMS) for T2 claims, per SM 00610.772B.7.

Manually control debts for T16 claims and debts owed to claimants, see GN 03920.052C.7 GN 03920.051D.8. in this section. For information on debts owed to the claimant, see GN 03920.051D.9. in this section.

Annotate a special message or remark regarding the incorrect payment to the Master Beneficiary Record (MBR) or Consolidated Claims Experience.

For more information regarding special messages and remarks, see SM 00510.075 for T2 and SM 01301.841 for T16.

7. Establish a diary

Technicians will establish a 45-day diary to follow up on the refund request. PCs may establish an ATFEE EXCESS diary through the Processing Center Action Control System (PCACS). For additional information on establishing PCACS diaries, see MS 04909.002 Diary Request Menu (DRMN). FOs may establish an issue on the Development Worksheet page or on the MDW screen.

For additional information on establishing FO follow-ups, see

MS 08122.004 Development Worksheet, and

MS 03901.002 Modernized Development Menu (MMEN).

8. Follow-up actions

a. The representative refunds the excess fee

If the representative refunds the excess fee payment to us, the technician will:

  1. 1. 

    Verify receipt (and clearance) of remittance. See the references below for remittance and returned fee payment processing instructions.

  2. 2. 

    Document recovery of the representative’s debt in the claimant’s electronic or paper file. If the FO or PC received the remittance but the Mid-Atlantic Program Service Center (MATPSC) Remittance and Accounting Unit (RAU) has not processed it, document the pending status of the remittance.

  3. 3. 

    After the MATPSC RAU processes the remittance for T2 claims, the remittance may require manual DMS and Payment History Update System (PHUS) annotation if an automated interface does not occur.

  4. 4. 

    After the MATPSC RAU processes the remittance for T16 claims, clear any manual controls for the representative’s debt.

For more information on remittance and returned fee payment processing, see:

GN 02403.006 Processing Remittances Received in the Field Office (FO)

GN 02405.010 How to Process Unendorsed Title II Returned Benefit Checks Received in the FO (Including Unendorsed Claimant Representative/Attorney Fee Checks)

GN 02405.100 How to Process Unendorsed Title XVI Returned Benefit Checks and Unendorsed Claimant Representative Attorney Fee Checks Received in the Field Office

MS DMS 003.003 PC Remittance Input (REMI)

MS DMS 003.008 Verif/Corr of FO Remittances (RFOV)

SM 01311.634 How to Resolve a B4 Diary

SM 00610.291 Completion of SSA-124-U3 for Misrouted Remittances

SM 00610.296 Allegation of Remittance

b. The representative did not refund the excess fee

If, after the 45-day diary expires, the representative has not refunded the full excess fee payment or if the representative intentionally misrepresented their direct payment eligibility (e.g., non-attorney claimed EDPNA status), we:

  1. 1. 

    Refer the matter to OGC for possible sanctions action, following the instructions in GN 03970.017 or GN 03970.025, along with any documentation (i.e., copy of the incorrect fee check(s), proof of direct deposit with the referral, copy of the remittance receipt.)

  2. 2. 

    If a response or remittance is received by the representative, update (if not locked) or add a new RPOC and send to OGC.

  3. 3. 

    Forward the new or updated report of contact to OGC, along with any new documentation (i.e., copy of the incorrect fee check(s), proof of direct deposit with the referral, copy of the remittance receipt) within 2 business days.

C. FO and PC instructions for recovering excess fee payments made to an entity

1. Confirm that the excess fee meets the conditions for pursuing recovery from an entity

When FO or PC technicians identify a potential excess fee issue, they must first ensure that the excess fee is one for which we will pursue recovery and that the excess fee was paid to the entity.

For more information on the circumstances under which we will pursue recovery of an excess fee, see GN 03920.051B.

2. Issue a notification of collection action to the entity’s POC and document the situation

If the excess fee issue meets the criteria for pursuing recovery and the fee in question was paid to an entity, the technician issues a Notification of Collection Action to Entity (MAO104). This notice can be created using the Document Processing System (DPS) or AURORA, and it should be addressed to the entity’s POC.

The technician then establishes an ATFEE issue through the Processing Center Action Control System (PCACS) and establishes a 30-day diary to follow-up on the refund request.

When establishing the ATFEE issue in PCACS, technicians should include the following information in the additional remarks section:

  • •

    The amount of the excess fee payment;

  • •

    The name and Employer Identification Number (EIN) of the entity involved;

  • •

    The name and Rep ID of the entity’s POC;

  • •

    The fee process involved (fee petition or fee agreement);

  • •

    The date of the fee authorization;

  • •

    The past-due benefit period and amount (include amounts for the claimant and any affected auxiliaries);

  • •

    The names and Rep IDs of any representatives involved, their dates of appointment, and the date(s) they assigned the right to direct payment of their fee to the entity, if applicable;

  • •

    A brief description of the excess fee issue; and

  • •

    An indication of whether we correctly paid the claimant and any affected auxiliaries.

3. Follow-up after the initial diary expires

Once the initial 30-day diary has expired, the technician queries DMS and PCACS to determine whether the entity has refunded the entire excess fee.

  • •

    If the entity has refunded the entire excess fee payment, the technician updates PCACS to reflect that full payment of the excess fee has been received. Clear any pending diaries in PCACS.

  • •

    If the entity has not refunded the entire excess fee payment, the technician proceeds to step 4.

4. Issue a final notification of collection action to the entity’s POC and establish a second diary

If the entity has not refunded the full excess fee payment by the expiration of the first 30-day diary, the technician issues a second, final recovery notice, Final Notification of Collection Action to Entity (MAO105). This notice can be created using DPS or AURORA, and it should be addressed to the entity’s POC.

The technician will then update the ATFEE issue previously established in PCACS and set a new 30-day diary to follow-up on the refund request.

When updating the ATFEE issue in PCACS, the technician should ensure that the information listed in GN 03920.052C.2. has been input in the remarks section. If any information is absent, the technician will include it.

In addition, the technician adds the following information:

  • •

    The amount of the excess fee payment that has been refunded, if applicable;

  • •

    The amount that has not yet been remitted.

  • •

    The date the initial notification of collection action was issued; and

  • •

    Any other relevant information related to the fee recovery process, including whether the entity’s POC has contacted us.

5. Follow-up after the second diary expires

Once the final 30-day diary has expired, the technician queries DMS and PCACS to determine whether the entity has refunded the entire excess fee.

  • •

    If the entity’s POC has refunded the entire excess fee payment, the technician updates PCACS to reflect that full payment of the excess fee has been received. Clear any pending diaries in PCACS.

  • •

    If the entity has not refunded the entire excess fee payment, or has refunded only part of it, the technician proceeds to step 6.

6. Refer the Entity-related Fee Issue to the IDPE Coordinator Group

If the entity does not refund the full excess fee by the expiration of the second diary, the FO or PC technician seeks management approval to refer the issue to the IDPE Coordinator Group.

If management approves, the technician:

  • •

    Refers the entity to the DCO Central IDPE coordinator’s mailbox for immediate action by sending an email to IDPEcoordinatorgroup@ssa.gov. See the example email.

  • •

    Update PCACS with the following message “IDPE Referral made on [insert date].”

  • •

    Close any open diaries in PCACS.

The subject line of the referral email should be “IDPE Referral for [Entity name and EIN].

The body of the email may be formatted as follows:

Re: [Claimant Name and SSN]

Good [Morning/Afternoon],

We are referring [Entity Name, EIN] for potential action by the IDPE Coordinator Group. An excess fee of [Full Excess Fee] was paid to this entity on [Fee Payment Date]. Based on the criteria in [Cite the applicable recoverable excess fee provision in GN 03920.052B, we identified this payment as an excess fee requiring recovery.

We sent collection notices to the entity’s POC on [Date of First Collection Notice] and [Date of Final Collection Notice], but as of today, [Remaining Excess Fee] remains unremitted. Please see the information below for more details.

[Include any information that is relevant to recovering the excess fee. This includes but is not limited to:

  • •

    The claimant’s SSN and name.

  • •

    The name and EIN of the entity involved;

  • •

    The name and Rep ID of the entity’s POC;

  • •

    The names and Rep IDs of any representatives involved, their dates of appointment, and the date they assigned the right to direct payment of their fee to the entity, if applicable;

  • •

    The fee process involved (fee petition or fee agreement);

  • •

    The past-due benefit period and amount (include amounts for the claimant and any affected auxiliaries);

  • •

    The date of the fee authorization;

  • •

    The date the fee authorization was amended or reversed by decision maker or person with fee setting authority, if applicable;

  • •

    An explanation of the excess fee payment;

  • •

    The dates of the first and final notice collections notice; and

  • •

    An indication of whether we correctly paid the claimant and any affected auxiliaries.

Once the referral has been submitted, no further action is required of the FO or PC technician. The IDPE Coordinator Group will not generally provide updates to the referring technician.

7. Responding to excess fee-related inquiries received after the issue has been referred to the IDPE Coordinator Group

If an FO or PC technician receives an inquiry from an entity’s POC about an issue that relates to the IDPE list or other excess fee-related matters, the technician may access the IDPE list in RASR for information on an entity’s status and any unresolved fee issues.

Technicians may provide any necessary information needed to resolve the excess fee matter, including but not limited to:

  • •

    Claimants’ SSN,

  • •

    IDPE status,

  • •

    Ineligibility Start or End Date, and

  • •

    Amount Owed.

D. Processing remittances by an entity’s point of contact

If an FO or PC technician receives a remittance from an entity’s POC, the technician:

  • •

    Checks the PCACS record to verify the full excess fee amount that we assessed and the amount that has been refunded.

  • •

    Processes the remittance. See the references below for remittance and returned fee payment processing instructions.

  • •

    Documents the pending status of the remittance in PCACS, if the Mid-Atlantic Program Service Center (MATPSC) Remittance and Accounting Unit (RAU) has not processed it.

  • •

    After MATPSC RAU processes the remittance for Title II claims, query the remittance for manual DMS and PHUS annotation if an automated interface does not occur.

  • •

    Checks the IDPE list in RASR to determine whether there is an IDPE entry related to this excess fee. If the excess fee appears on the IDPE list, email the IDPE Coordinator Group at the IDPECoordinatorgroup@ssa.gov mailbox and notify them of the amount remitted. Include a copy of the payment receipt as an email attachment.

For more information on remittance and returned fee payment processing, see:

GN 02403.006 Processing Remittances Received in the Field Office (FO)

GN 02405.010 How to Process Unendorsed Title II Returned Benefit Treasury Checks and Unendorsed Claimant Representative Attorney Fee Checks Received in the Field Office

GN 02405.100 How to Process Unendorsed Title XVI Returned Benefit Checks and Unendorsed Claimant Representative Attorney Fee Checks Received in the Field Office

MS DMS 003.003 PC Remittance Input (REMI)

MS DMS 003.008 Verif/Corr of FO Remittances (RFOV)

E. IDPE Coordinator Group instructions for maintaining the IDPE list

When the IDPE Coordinator Group receives a referral from the FO or PC the IDPE group will:

  • •

    Verify there is still an excess fee amount due after accounting for any remittances.

  • •

    Ensure that the notices in GN 03920.052C.2 and 03920.052C.4 in this section have been issued.

  • •

    Use the RASR IDPE screen to create a record with the entity’s EIN and the claimant’s SSN to document the specific fee issue and excess fee amount owed.

  • •

    Document in the comments the attempts to recover, any contacts with the entity POC, and other relevant information.

  • •

    After generating a record, RASR send the entity a Notification of Action to Terminate Eligibility for Direct Payment to Entity (RSR-122).

Once a record has been established on the IDPE list, the entity will be ineligible for direct payment until this and all other fee issues documented on the IDPE list are resolved. The IDPE Coordinator Group updates the IDPE records when warranted, such as when a fee remittance is received.

NOTE 1: Each instance of an erroneous or excess fee payment creates a new record for the specific EIN. All excess fee issues documented on the IDPE list must be resolved for the entity to be removed from the IDPE list.

NOTE 2: RASR will not automatically generate a notice if the entity is already ineligible for direct payment at the time a new IDPE record is generated. However, the entity will remain ineligible for direct payment until all excess fee issues documented in the IDPE list are resolved.

 

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To Link to this section - Use this URL:
http://policy.ssa.gov/poms.nsf/lnx/0203920052
GN 03920.052 - Pursuing Recovery of Excess Fees Paid to Representatives or Entities and Referrals for Ineligible for Direct Payment Entity (IDPE) List - 12/06/2024
Batch run: 12/19/2024
Rev:12/06/2024