Bureau of Special Investigations 1st Quarter Report--Fiscal Year 2021

In the first quarter of Fiscal Year 2021 the Bureau of Special Investigations identified over $1.1 million in public benefit fraud.

About the Bureau of Special Investigations

Operating as a division within the Office of the State Auditor, the Bureau of Special Investigations (BSI) is charged with investigating allegations of public assistance fraud throughout the Commonwealth.The work of BSI fraud examiners ensures taxpayer dollars used to fund Massachusetts’ public benefits programs are managed effectively so that programs are available to residents who truly need them.

Under state law, BSI’s investigative authority extends to any assistance program administered by the Department of Transitional Assistance (DTA), the Department of Children and Families (DCF),  and the Division of Medical Assistance, which administers MassHealth (the state’s Medicaid program). Although the Department of Early Education and Care (EEC) is not included in the BSI statute, BSI also works with EEC through a Memorandum of Understanding. As a result of BSI’s investigations, public assistance fraud cases are referred to agencies for administrative action, fraudulent overpayments are recovered through civil agreements, individuals are disqualified from programs for specified periods of time, and cases are prosecuted in state and federal courts.

Pursuant to M.G.L. c.11, §17, BSI fraud examiners operate from five offices across the Commonwealth. BSI consists of three separate investigative units: the Central Processing Unit; the MassHealth, Department of Transitional Assistance, and Early Education and Care Unit; and the Data Analytics Unit. While each unit has its own specific concentration, there is extensive cross-unit collaboration, and investigations often involve overlap. BSI also participates in joint investigations and task forces with other state and federal agencies that focus on combating fraudulent activities throughout the Commonwealth.

During Quarter 1 of fiscal year 2021¹, BSI² investigated a total of 713 cases. Of these, 50 were completed with fraud identified. Further detail regarding these 50 cases may be found below. As BSI was unable to conduct civil recovery interviews this quarter, there are no restitution settlements to report.

Summary of Investigations Completed with Fraud Identified

Assistance type	Amount	% of total
Medicaid	$541,529.33	47%
Supplemental Nutrition Assistance Program (SNAP)	$400,278.00	35%
Transitional Aid to Families with Dependent Children (TAFDC)	$85,296.30	7%
Early Education and Childcare (EEC)	$66,149.81	6%
Emergency Aid to the Elderly, Disabled, and Children (EAEDC)	$56,327.82	5%
Total	$1,149,581.26	100%

Additional Resources

Bureau of Special Investigations 1st Quarter Report - Fiscal Year 2021

1. In response to the Covid-19 Pandemic, OSA/BSI offices closed on March 13, 2020, and BSI suspended all field-work including in-person interviews and civil recoveries until further notice. Additionally, its agency partners shifted their focus from fraud investigations, to eligibility determination.  Therefore, BSI’s agency partners referred approximately 60% fewer cases during FY 2020 Q4 as opposed to FY 2019 Q4 (687 fraud referrals FY 2020 Q4 vs. 1,147 fraud referrals FY 2019 Q4)

2. Please note that BSI does not collect settlement payments of any kind; the individual benefit programs are responsible for collection activities related to BSI cases settled through civil recoupment or criminal prosecution. Therefore, BSI is unable to report on monthly collections or circumstances that produce shortfalls in collections.

Date published:	October 15, 2020