For Immediate Release - August 18, 2011

Auditor’s Office ID’s $1 Million in Public Assistance Fraud

Bump releases report on Bureau of Special Investigations cases

(Boston, MA)-In a quarterly progress report issued today, State Auditor Suzanne M. Bump said examiners with the office’s Bureau of Special Investigations (BSI) completed investigations of 1,274 people accused of defrauding the state and documented over a million dollars of illegal activity in obtaining public assistance benefits and services during the final three months of the state’s fiscal year.

Auditor Bump said BSI examiners identified 163 people who tried to cheat the state out of welfare, food stamps, childcare services, health care benefits, public housing or cash assistance.

“Every dollar that’s paid out in a fraudulent claim, means one less dollar for those who are struggling to make ends meet,” said Auditor Bump. “BSI examiners identify millions of dollars in fraud every year.”

During the last fiscal year, which ended June 30, 2011, BSI received 2,419 complaints of suspected fraud and found $4.3 million in fraudulent claims. Examiners identified the largest percentage of illegally obtained funds, 65%, in MassHealth programs such as Medicaid and Personal Care Attendants.

BSI examiners work with dozens of state agencies and turn over documented illegal activity to the appropriate law enforcement agency for potential criminal prosecution or the appropriate state agency to recoup illegally obtained funds.

The report highlights one such case of Medicaid fraud in which a Hampden County woman assumed her deceased mother’s identity and claimed her as a personal care attendant (PCA). The woman also hired her spouse, brother and daughter as her PCA’s and submitted dozens of so-called “daily activity forms” that entitled her to $280,255 in Medicaid reimbursements. BSI examiners determined that the woman received all payroll checks intended for her PCA’s and cashed them herself. In May, the woman pled guilty in Hampden County Superior Court to eight counts of MassHealth fraud and eight counts of larceny as a result of BSI’s referral of the case to the Attorney General.

She was ordered to pay $139,161 in restitution and sentenced to two years in the House of Corrections, which was suspended for 12 years.

While the majority of allegations of public assistance fraud come from MassHealth and the Department of Transitional Assistance, the public can also file a complaint through the BSI fraud hotline (617) 727-6771 or by sending an email to infoline@sao.state.ma.us. All complaints are kept confidential.

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BSI Report: Bureau of Special Investigations Fourth Quarter Report – FY2011 pdf format of BSI Fourth Quarter Report – FY2011