Massachusetts total identified fraud more than doubled in FY22 to over $13 million

Boston — This week, State Auditor Suzanne M. Bump released the final annual fraud report of her tenure. The Bureau of Special Investigations identified $13,519,349.55 in public assistance fraud in fiscal year ending on June 30, 2022. The total identified fraud more than doubled between FY21 ($6,139,720.51) and FY22 ($13,519,349.55). The increase in identified fraud is largely attributable to an increase in pre-pandemic levels of cases referred by the public benefits agencies for investigation and emanating from its own data analytics unit.

“BSI has been transformed. Its data analytics unit now proactively identifies patterns of fraud, enabling the unit to do more than react to benefits agencies’ referrals. BSI’s collaboration with state and federal agencies are yielding better results and are enabling our fraud examiners to work on high-profile, high dollar cases,” said Auditor Bump. “The fraud examiners themselves are better trained in their work and in courtroom presentations, and have genuine career paths. The case management system Director Gina Cash has newly implemented is already showing its value. I heartily congratulate her on her leadership.”

“Since 2011, I have had the privilege to lead this agency and oversee the impact in many areas of state government, specifically areas of fraud and abuse. The initiatives implemented throughout my tenure have focused on data reliability, transparency and accountability,” said Bump. “Most importantly, BSI has built and maintained strong relationships and communication with state agencies as well as stakeholders to better serve the public. Although this is my final BSI report as State Auditor, I am proud to provide the next Auditor with this report as a roadmap to continue BSI’s outstanding work in combating fraud and abuse in public benefit programs serving residents of the Commonwealth.”

Lastly, this report highlights notable activity surrounding BSI’s cases since last year, including:

-The Central Processing Unit (CPU) received 5,191 new referrals for investigation in fiscal year 2022 (FY22) and processed, analyzed, and reviewed 3,636 referrals.

-The Super Fraud Unit (SFU) completed 688 investigations in FY22, which contributed to identifying fraud totaling $9,047,145.31 in 544 cases.

-The Data Analytics Unit (DAU) generated 387 referrals to CPU, the majority of which alleged that personal care attendants (PCAs) failed to accurately disclose their income to the Department of Transitional Assistance (DTA) and MassHealth agencies as required while receiving public assistance benefits.

-120% increase in the total amount of identified fraud; and

-61% increase in new referrals received

BSI investigates programs administered by DTA, and the Division of Medical Assistance (which administers MassHealth). In addition, BSI has an agreement with the Department of Early Education and Care to investigate fraud in that program as well. BSI receives referrals for investigation from its agency partners, public tips, referrals from federal agencies, and through the use of its data analytics tools. The public can report potential fraud to BSI at: https://www.mass.gov/how-to/report-public-benefit-fraud-to-the-office-of-the-state-auditor