State Auditor Identified Record $16.9 Million in Public Assistance Fraud in Fiscal Year 2017

BOSTON — State Auditor Suzanne M. Bump today released the annual report for her office’s Bureau of Special Investigations (BSI), which identified a record $16.9 million in public assistance benefit fraud in Fiscal Year 2017—a nine percent increase over the previous year. This marks the seventh straight year of increased findings by Bump’s office. The increased findings is not an indication of more fraud in these programs, but rather a reflection of the growing effectiveness of Bump’s agency and expanded use of data analytics to identify fraudulent activities.

“Public benefit programs play a critical role in the health and well-being of our state’s most vulnerable residents, from children to the elderly,” Bump said of the annual report. “Our work identifies and roots out those individuals abusing the system in order to strengthen the integrity of these programs for those who need them. BSI has done impressive work effectively utilizing data analytics to proactively identify potential incidences of fraud, further strengthening this important safety net. ”

In total, Bump’s office identified $16,879,702.88 in fraud, spread over 1,150 completed investigations. The majority of the fraud–$10,302,458.47 or 61 percent—was identified in the MassHealth program.

During the year, BSI investigations resulted in:

• An East Boston woman pleading guilty in federal court for fraudulently obtaining public benefits. She was ordered to pay over $50,000 in restitution to the Social Security Administration and over $40,000 in restitution to MassHealth;
• A Rhode Island man pleading guilty to fraudulently receiving more than $45,000 in MassHealth benefits and $8,324 in DTA benefits; and
• A Fall River woman being sentenced for identity theft. She was sentenced to 27 months in prison, three years of supervised released, and restitution of nearly $300,000 to the Social Security Administration, the Massachusetts State Supplemental Program, MassHealth, and the Department of Transitional Assistance (DTA).

As State Auditor, Bump has made it a priority to strengthen the integrity and accessibility of public assistance programs. In addition to identifying fraud in these programs, last year, her office began a series of audits to identify barriers that individuals face when seeking assistance from public benefit programs. As part of this effort, Bump’s office has provided recommendations to reduce these barriers at the Catastrophic Illness in Children Relief Fund and the Department of Veterans’ Services.

Public benefit programs are designed to provide needed assistance to the Commonwealth’s most vulnerable and disadvantaged residents. According to recent reports from MassHealth and DTA, fifty-eight percent of MassHealth members and 91 percent of the state’s Supplemental Nutritional Assistance Program (also known as SNAP or food stamps) beneficiaries are either children, disabled adults, or seniors. Furthermore, 72 percent of households receiving SNAP benefits had a gross income below the Federal Poverty Level – $24,300 for a household of four.

The Office of the State Auditor’s Bureau of Special Investigations investigates allegations of public assistance fraud throughout the Commonwealth. Its work ensures taxpayer dollars are used effectively and that benefits are available to residents who truly need and qualify for them. 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 (EEC) 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