Press Release State Auditor’s Office Identified Record $13.7 Million in Public Assistance Fraud

Boston — State Auditor Suzanne M. Bump today released the annual report for her office’s Bureau of Special Investigations (BSI), which identified a record $13.7 million in public assistance benefits fraud in Fiscal Year 2015. This represents a 44 percent increase over the previous year’s record of $9.5 million and is the fifth straight year of record-setting findings.

“At a time when government and families are tightening their belts, our work to investigate fraud strengthens the fabric of our social safety net, ensuring these programs are available for the most vulnerable individuals and families in the Commonwealth,” said Bump. “By strengthening the integrity of these programs, we’re also providing Massachusetts residents with confidence that their tax dollars are being used effectively.”

BSI examiners completed 10,784 investigations in FY15, with fraud identified in 1,131 of those cases, a 37 percent increase in fraud identification from FY14. These cases included individuals or groups defrauding the state of public assistance benefits like: food stamps (SNAP), childcare services, health care benefits, and cash assistance.

“The return on investment of BSI has roughly doubled since 2012,” said Bump. “In the last fiscal year, for every dollar invested in BSI, $6.17 in fraud was identified. BSI’s Data Analytics Unit provided an even higher return on investment of $9.08 for every dollar.”

Bump went on to note that the increased findings of fraud do not necessarily indicate more fraud in these programs, but is reflective of greater effectiveness by the agency in identifying fraudulent behavior. BSI has also begun working with additional state agencies to improve and expand the referral process, ensuring that those agencies can report suspicions of fraud to BSI.

BSI examiners work with state and federal agencies, including the Department of Transitional Assistance, MassHealth, the US Department of Agriculture, both the US and Massachusetts Attorneys General, and other government agencies to document fraudulent activity. Investigations focus both on tips related to individual recipient fraud, as well as provider fraud. The work leads to both prosecution and recovery of funds.

The report also underscores notable achievements and case highlights of BSI. During the year, BSI was the only state agency invited to join a federal task force on public assistance fraud. Other members of the task force include the US Departments of Labor, Homeland Security, Veterans Affairs, and Health and Human Services, as well the US Postal Service. Through this task force, BSI exchanges fraud referrals with federal agencies, makes valuable contacts, and improves its investigative techniques and resources.

Also of note, the report provides examples of fraud cases uncovered by BSI, including the examination of a South Shore adult day health provider that was identified using the Bureau’s data analytics capabilities. This provider was billing and receiving payments for member who, at the time, were in facility-based settings, a practices which is prohibited. This resulted in more than 95,000 improper claims, totaling over $3 million. This investigation is ongoing.

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 at (617) 727-6771 or by sending an email to infoline@sao.state.ma.us. All complaints are kept confidential.

The BSI FY15 Annual Report is available here.

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