Bureau of Special Investigations Quarter One Report - Fiscal Year 2025

During Quarter 1 of fiscal year 2025, BSI identified $2,549,324.63 in fraud and had $457,616.10 in civil recoveries.

Overview

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.

Pursuant to M.G.L. c.11, §17, 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 BSI’s enabling 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.

BSI fraud examiners operate from five offices across the Commonwealth. BSI consists of three separate investigative units: the Central Processing Unit; the Fraud Investigations Unit¹; 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. BSI cases are enforced by other agencies and may be settled through civil recoupment or criminal prosecution. BSI is not enabled under our governing statute to collect settlement payments of any kind; the individual benefit programs are responsible for collection activities related to BSI cases.

During Quarter 1 of fiscal year 2025, BSI investigated a total of 814 cases and received overpayment calculations in 207 cases with identified fraud. Further details regarding these 207 cases may be found below. 

Summary of Investigations Completed with Fraud Identified

Assistance type	Amount	% of total
Supplemental Nutrition Assistance Program (SNAP)	$1,528,615.00	60%
Medicaid	$568,517.13	22.3%
Department of Early Education and Care (EEC)	$307,324.63	12.1%
Transitional Aid to Families with Dependent Children (TAFDC)	$112,787.47	4.4%
Emergency Aid to the Elderly, Disabled, and Children (EAEDC)	$28,392.66	1.1%
Personal Care Attendant (PCA)2	$3,719.10	0.1%
Grand Total	$2,549,324.63	100%
Restitution Settlements (Civil Recoveries)3	$457,616.10

1. Formerly the MassHealth, Department of Transitional Assistance, and Early Education and Care Unit.
2. PCA cases identify MassHealth overpayments for PCA services; overpayments for member healthcare benefits are identified by Medicaid.
3. BSI is unable to report on monthly collections or circumstances that produce shortfalls in collections. Restitution settlements are ongoing and continue beyond the issuance of this report. While this report informs the public of what we have found to date, benefit programs require time to implement and manage collections.

Date published:	February 18, 2025
Last updated:	February 18, 2025