MICHIGAN DEPARTMENT OF HUMAN SERVICES Office of Inspector

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MICHIGAN DEPARTMENT OF HUMAN SERVICES Office of Inspector General Budget Presentation – February 20,

MICHIGAN DEPARTMENT OF HUMAN SERVICES Office of Inspector General Budget Presentation – February 20, 2013

Office of Inspector General (OIG) 2 § Criminal Justice Agency within Department of Human

Office of Inspector General (OIG) 2 § Criminal Justice Agency within Department of Human Services (DHS), created in 1972 § Governed by State law § 130 Staff On-Board, 118 Field Positions. § Agents strategically located throughout Michigan to provide investigative coverage for every county of Michigan

OIG Mission 3 The mission of the Office of Inspector General (OIG) is to

OIG Mission 3 The mission of the Office of Inspector General (OIG) is to assist the Michigan Department of Human Services in maintaining integrity and accountability in the administration of its programs. The OIG provides investigation and advisory services to ensure appropriate and efficient use of available public resources.

OIG RESPONSIBILITIES 4 Investigate: § Recipient fraud § Vendor - Contractor fraud § Provider

OIG RESPONSIBILITIES 4 Investigate: § Recipient fraud § Vendor - Contractor fraud § Provider fraud § Employee fraud (Internal Affairs)

Specialized Units 5 § Investigative Analytics Unit (IAU): § Data mining/analytical support of the

Specialized Units 5 § Investigative Analytics Unit (IAU): § Data mining/analytical support of the office § Special Investigations Unit (SIU): § Specializing in major investigations and internal affairs investigations § Trafficking Unit: § Specializing in FAP trafficking investigations

Recipient Integrity Activities 6 § Front End Eligibility (FEE) Investigations: Fraud Prevention - Referrals

Recipient Integrity Activities 6 § Front End Eligibility (FEE) Investigations: Fraud Prevention - Referrals based on questionable information in public assistance applications prior to case opening and payment of benefits § Internal referrals based on OIG data analytics § Recipient Fraud Investigations: § Unreported income § Unreported assets § Misrepresentation of household circumstances § Trafficking § Hotline - Internet complaints §

High Risk Areas 7 § Bridge Card Trafficking § Internet “IP Address” Tracking §

High Risk Areas 7 § Bridge Card Trafficking § Internet “IP Address” Tracking § Assists in identifying the physical location of persons applying for benefits online (Mi. Br § PARIS: Interstate Match § Indicator of individuals receiving duplicate assistance

High Risk Areas II 8 § Social Media Monitoring § Identifies individuals selling FAP

High Risk Areas II 8 § Social Media Monitoring § Identifies individuals selling FAP benefits § Out-of-State EBT Transaction Monitoring § Indicator of household living out of MI while on public assistance in MI § Bridge Card Transaction Trend Analysis § Identifies evolving FAP Trafficking trends § Multiple Bridge Card Replacement § Indicator of FAP trafficking (selling EBT card)

Bridge Card Trafficking 9 § The buying and selling of Bridge Card benefits for

Bridge Card Trafficking 9 § The buying and selling of Bridge Card benefits for cash and/or other prohibited items

Bridge Card Trafficking 10 2” Bullet Proof Glass; Lack of Counter Transactions of $80

Bridge Card Trafficking 10 2” Bullet Proof Glass; Lack of Counter Transactions of $80 -$200 were common at this location within minutes of each other

Raid Photo Meat expired in April of 2001 Store was raided 10 years later!

Raid Photo Meat expired in April of 2001 Store was raided 10 years later!

Raid Photo Eggs expired in September of 2009 (Raid occurred approximately 18 months later)

Raid Photo Eggs expired in September of 2009 (Raid occurred approximately 18 months later)

Raid Photo Nearly Empty Cooler

Raid Photo Nearly Empty Cooler

FAP Trafficking Efforts 14 OIG has made FAP trafficking investigations a priority. § Prioritization

FAP Trafficking Efforts 14 OIG has made FAP trafficking investigations a priority. § Prioritization of investigative resources (Trafficking Agents) § Identification of retailers and recipients § Partnered investigations with federal, state and local law enforcement agencies § Public and media outreach

OIG Trafficking Unit Statistics 15 § $5. 8 Million in Trafficked Benefits Identified §

OIG Trafficking Unit Statistics 15 § $5. 8 Million in Trafficked Benefits Identified § $4. 1 Million in Fraud Receivables Established § 1, 652 Trafficking Cases Completed § 184 IPV Hearings Conducted

i-Sight Case Management System (in development) 16 § Integration of three disparate databases §

i-Sight Case Management System (in development) 16 § Integration of three disparate databases § Front End Eligibility (FEE) § Recipient Fraud § Provider/Employee Fraud § Automated Functionality Upgrades § Development of an automated fraud tool from data warehouse – Improve Analytics, Increase Efficiency, Improve Investigative Outcomes. § Improved communication to Field Agents and Prosecutors

Recipient FAP Fraud FY 2012 17 § 9, 907 FAP Recipient Fraud Investigations §

Recipient FAP Fraud FY 2012 17 § 9, 907 FAP Recipient Fraud Investigations § 7, 702 Fraud (IPV) Dispositions § $14. 2 Million in FAP Recipient Fraud § § 975 Criminal Warrants 1, 124 IPV Hearings – IPV Established § 4, 400+ FAP IPV Disqualifications § IPV DQ = $13 M in Cost Avoidance § $11. 3 Million in FAP Fraud Receivables

OVERALL STATISTICS FY 2012 18 § 30, 296 FEE and Fraud Complaints 11, 497

OVERALL STATISTICS FY 2012 18 § 30, 296 FEE and Fraud Complaints 11, 497 Recipient Fraud complaints § 16, 900 FEE investigations completed § 6, 065 recipient fraud investigative dispositions. § Recipient Fraud found: $22. 6 Million § Revenue generated: $19. 7 Million in fraud receivables §

FY 2012 Cost Savings 19 Front End Eligibility $69, 584, 900 § Recipient Fraud

FY 2012 Cost Savings 19 Front End Eligibility $69, 584, 900 § Recipient Fraud /IPV $22, 690, 534 § IPV Disqualifications $14, 419, 620 § Special Investigations $5, 723, 544 ________________ TOTAL SAVINGS $112, 418, 599 §

Front End Eligibility (FEE) 20 Return on Investment § FEE deters fraud; prevents improper

Front End Eligibility (FEE) 20 Return on Investment § FEE deters fraud; prevents improper payments and reduces errors. Provides eligibility workers with a resource for accurate case openings. § Every dollar spent on FEE investigation efforts resulted in program cost savings of $26. 00

Fraud Dollars Established by Program 21

Fraud Dollars Established by Program 21

Receivables Established 22 $20 $15 $10 $5 $0 FY 2010 11. 3 M FY

Receivables Established 22 $20 $15 $10 $5 $0 FY 2010 11. 3 M FY 2011 11. 4 M FY 2012 19. 7 M

QUESTIONS 23 Alan Kimichik, Inspector General (517) 335 -3899 www. michigan. gov/dhs

QUESTIONS 23 Alan Kimichik, Inspector General (517) 335 -3899 www. michigan. gov/dhs