Massachusetts Auditor Diana DiZoglio’s office identified more than $12.3 million in public benefit fraud in fiscal year 2023, representing a drop of about $1.2 million compared to her predecessor’s findings in the year prior.
The state auditor’s Bureau of Special Investigations, tasked with examining potential fraud connected to payments intended to support vulnerable residents, such as low-income families and children, detected fraud totaling $12,322,688 from July 1, 2022 through June 30, 2023, according to a newly released report.
That compares to the $13,519,349 in fraud that the bureau identified in fiscal year 2022 under then-state Auditor Suzanne Bump, who served in office for about half of fiscal year 2023. DiZoglio’s office said that the Bureau of Special Investigations completed 5,100 fraud investigations, a nearly 41 percent increase over last year’s 3,623 investigations.
“For many residents across the state, public benefit programs provide access to everyday essential items – such as food and medical supplies. It is through the efforts of our fraud examiners that we continue to help ensure public benefit programs operate with transparency, accountability, and equity,” DiZoglio said in a written statement. “Our office will continue to work to ensure taxpayer dollars are used effectively and that resources are available to those who truly need and qualify for them.”
Investigators identified fraud within 782 completed cases, with an average fraud amount of about $15,758. The Bureau of Special Investigations said operational challenges during the COVID-19 pandemic “decreased significantly” in 2023, which translated into increased referrals and fewer delays in fraud calculations.
Nearly 70 percent of the fraud dollars, or about $8.5 million, involved the state Department of Transitional Assistance. Another 27 percent of the fraud, or about $3.3 million, was tied to MassHealth. Other fraud dealt with the state Department of Early Education and Care and the Social Security Administration.
Fraud examiners can refer cases for prosecution or seek civil recoveries, among other remedies.
The report warns that in some instances, a closed case without fraud “does not necessarily indicate that fraud was not committed.” Rather, the report states, “it’s more likely that BSI was not able to obtain the necessary documentation to substantiate the fraud, or that the individual was not receiving public assistance benefits during the period of the allegation.”
In “notable” bureau activity for the year, officials say a pending case in Essex Superior Court involves a Lynn woman accused of stealing about $24,330 in Supplemental Nutrition Assistance Program benefits from May 2020 through April 2022. That follows a separate case in which the woman was accused of stealing child care and SNAP benefits for about a decade by providing false information to the state.
A Quincy woman is barred from working as a MassHealth provider following multiple fraud indictments, including billing for services that didn’t happen and submitting false claims to MassHealth.
A pending case in Barnstable County Superior Court involves with a Marston Mills woman who was indicted over fraudulent child care and Department of Transitional Assistance (welfare) benefits.
“The indictment alleges that between 2015 and 2020, the woman failed to report her spouse, the father of her children, as a part of her household and that she failed to report his income,” the report states. “As a result, his income was not counted when the benefits programs determined her eligibility and it is alleged she stole approximately $110,890.99 in EEC benefits from June 2015 through November 2020, $29,177 in SNAP benefits from January 2015 through January 2019, and $3,927.55 in TAFDC benefits from May 2018 through August 2018.”
TAFDC stands for Transitional Aid to Families with Dependent Children.
As part of a joint investigation with MassHealth and state Attorney General Andrea Campbell’s office looking into fraud among personal care attendants, the state Auditor’s Bureau of Special Investigations said it found one woman who used her married name to seek care and her maiden name to apply as the caregiver.
“The subject submitted timesheets and was paid for the PCA services she fraudulently indicated that she provided to herself. The calculated amount of overpayment totaled $36,897.30 for approximately two years of fraud,” the report said, which noted the case made it to Worcester Superior Court.
PCA stands for personal care attendant.
Following indictments of larceny and medical assistance fraud, “the subject was sentenced to one year committed in a house of corrections on both counts to run concurrent with 200 days credited as time served,” the report said.
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