Information about the Benefit Accuracy Measure (BAM) Program

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About the Benefit Accuracy Measure (BAM) Program

The Benefit Accuracy Measurement (BAM) program is a federally mandated quality control program in accordance with 20 Code of Federal Regulations, Part 602. The BAM program audits Unemployment Insurance (UI) claims to assess the accuracy of benefits paid and benefits denied to claimants. The Department of Unemployment Assistance (DUA) uses BAM audit findings to ensure compliance with federal and state laws, rules, and policies as well as to reduce improper payments.

Why is the claim being audited?

  • The claim was randomly selected for participation in a federally mandated audit program
  • Audits are used to assess the agencies accuracy in paying and denying benefits to claimants
  • Audit results assist the agency in ensuring the accuracy of UI program implementation, and improving the administration and performance of the UI program

How will you know if your claim was selected?

  • You will receive notification from the investigator auditing your claim.
  • If you have returned to work, the investigator will provide a method through which you can provide requested information.

What does the audit include?

The audit examines and validates existing claim records and data such as, but not limited to:

  • Claimant statements
  • Employer statements
  • Wage and employment verification from any employment in the 15 months prior to filing the claim
  • Worksearch activity verification
  • Availability and capability review
  • Other eligibility issue(s) review

How is the audit completed?

  • Claimant interview(s) include a detailed questionnaire about your claim, completed by telephone or email 
    • The BAM Investigator completing the audit is required to make a minimum of three attempts to obtain information
    • These questions are similar to the information requested when the claim was filed
    • Additional contacts may be required when information is missing, clarification is needed, and/or when there is a potential for overpayment
  • Former employers may be contacted to verify payroll records, provide separation information
  • All existing eligibility issues will be reviewed and re-investigated
  • New eligibility issues that arise from the audit will be investigated
  • Worksearch logs will be investigated to substantiate worksearch activities listed 
  • Based on all available information, the Investigator will determine if the claim was paid properly or denied properly
  • If payment or denial are deemed improper, the claim will be modified to reflect BAM audit outcomes

How does the audit affect my claim?

Using all information obtained during the audit, The BAM investigator must arrive to a supportable conclusion. The federal government requires that a claim be modified to enact conclusions from BAM audit. The investigator may conclude one of the following outcomes: 

  • The claimant’s eligibility was correctly determined
  • The claimant was overpaid
    • In accordance with MGL 151A §71, BAM findings can result in an overpayment of benefits. If there is a potential for the claimant to be overpaid, a notice of potential overpayment will be sent to the claimant
    • This notice will give the claimant 14 days to provide additional statements or documentation that might impact the outcome of the issue causing the overpayment
    • The claimant may waive the 14-day notice period, which allows the determination to be issued sooner
    • If denied, a written determination will be issued with all applicable appeal rights. 
  • The claimant was underpaid
    • A payment will be issued if the claimant is otherwise eligible
    • A written determination will be issued to employer, if entitled, with all applicable appeal rights

What happens if claimant does not participate?

  • Participation by claimant is strongly encouraged since BAM findings have the potential to affect the claimant’s past, present and future unemployment benefits
  • Because the audit is federally mandated, the audit will continue regardless of claimant participation.

Why are employers contacted? Employers are an integral part of the investigation.

The three main reasons why Benefit Accuracy Measurement investigators contact employers are:

  • To verify the past or present wages of the claimant selected for audit
  • To verify that the claimant performed the worksearch activities submitted in the worksearch log 
  • To verify the reason that caused the claimant’s total or partial unemployment
  • To verify benefit eligibility

Why is employer information necessary?

  • BAM investigators must verify wages because the right to collect benefits, plus the amount and duration of benefits, is based on previous earnings and any current earnings.
  • A person applying for or collecting unemployment insurance benefits must be able, available, and actively seeking work. Persons receiving unemployment insurance are asked to record all worksearch contacts/activities and the results of each contact. BAM investigators must contact employers, claimants listed on their worksearch log to verify the worksearch activity
  • To qualify for unemployment insurance, a person must have been fully unemployed or working reduced hours through no fault of his or her own. BAM investigators must contact employers to substantiate cause of separation or reduced hours 

How are employers contacted?

  • Employer interview(s) include a detailed questionnaire about the claim, completed by telephone or email 
    • The BAM Investigator completing the audit is required to make a minimum of three attempts to obtain information
    •  These questions are similar to the information requested when the claim was filed
    • Additional contacts may be required when information is missing, or clarification is needed 

What happens if an employer does not participate?

  • Participation by employer is strongly encouraged since BAM findings have the potential to affect the employers experience (tax) rating
  • Because the audit is federally mandated, the audit will continue regardless of employer participation
  • Employers are strongly encouraged to participate in the audit to preserve their appeal rights
  • In certain circumstances employers may be referred for an expanded audit conducted by the DUA Revenue Audit department

Will the program benefit employers?

  • Yes. Over the long-run, audit outcomes help the agency reduce improper payments through prevention and better detection of improper UI payments. These outcomes directly affect employers experience (tax) rating.

Employers can help by:

  • Promptly responding to a BAM investigator’s request for information
  • Providing information that is accurate to the best of their knowledge
  • Attending all unemployment insurance appeals hearings when requested to do so

Cooperation from employers enhances the success of the UI Program

 

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