Report Welfare Fraud

Welfare, which is government assistance given to individuals and families in need of financial support, is distributed by state agencies in order to help with basic living needs (e.g., medical support, food support, and financial support). Families can apply with their state's designated agency in order to receive benefits, provided they qualify. Different states and different programs have different qualifications, including those based on income, family size, and the number of children in a household. However, the system can be abused by people submitting fraudulent claims. If you have witnessed welfare abuse, you may want to report the fraud to your state's designated agency.

Steps

Understanding the Welfare System

  1. Know about Medicare and Medicaid. Medicare is health insurance offered to people 65 or older or to certain people with disabilities who are under the age of 65.[1] Medicaid is a federal and state program offered to help with the medical costs of certain people with limited incomes and resources.[1]
    • To be eligible, you will have to check with your state specific requirements. In general, those below a certain income level will automatically be eligible for Medicaid.[2] To be eligible for Medicare, you can check with the government website, which utilizes an eligibility calculator.[3]
    • Over 49 million people receive Medicare benefits and around 60 million people receive Medicaid benefits.[4] [5]
    • According to some, more than $27 billion has been returned to the Medicare Trust Fund since 1997 due to fraud.[6]
  2. Understand the Supplemental Nutrition Assistance Program (SNAP). SNAP offers food assistance to low-income individuals and families.[7]
    • To be eligible, applicants must meet certain income, employment, and immigrant status requirements.[8]
    • By some accounts, more than 46.5 million people participate in SNAP.[9]
    • SNAP has a payment accuracy rate (i.e., making sure the payment gets to the right person and in the right amount) of 96.19%, which means fraud within the SNAP program is extremely low.[10] [11]
  3. Know about federal Unemployment Insurance. Unemployment insurance provides benefits to eligible workers who become unemployed through no fault of their own.[12]
    • Every state has different eligibility requirements for receiving unemployment insurance. For example, in Connecticut, you must be monetarily eligible, must be partially or totally unemployed, must have lost your job for an approved reason, and must be actively looking for other employment.
    • At the end of 2014, only 23% of unemployed people were receiving unemployment insurance.[13]
    • In 2011, some people estimated that over $3 billion in fraudulent unemployment insurance payments were made.[14]
  4. Understand the federal disability benefit program. Disability programs are meant to provide financial support to individuals suffering from a recognized disability.[15]
    • To be eligible, an applicant will have to provide medical evidence that they have a disability that is recognized by the Social Security Administration.[15]
    • In 2013 it was estimated that around 8.8 million people received disability benefits.[16]
    • Fraud associated with disability benefits is said to be "extremely rare."[17]

Identifying Welfare Fraud

  1. Know the different forms of welfare fraud. Once you understand the basic structure of the welfare system, you need to know what types of fraud exist. In general, the term welfare fraud refers to the taking advantage of welfare benefits improperly or illegally in order to receive assistance when it should not be given. Welfare fraud often occurs when someone falsifies or leaves out critical information in their application to receive welfare benefits. The different types of welfare fraud include:
    • Falsifying household compositions and sizes;
    • Purposely not reporting income and/or employment updates;
    • Purposely not reporting other welfare programs someone is a part of;
    • Using false names to collect multiple benefits; and
    • Claiming welfare benefits in multiple states when not authorized to do so.[18]
  2. Determine the facts surrounding the potential fraud. If you suspect that someone is committing welfare fraud, gather as much factual evidence as possible. Write down what you see and be prepared to include the information in your fraud report. Depending on the type of fraud you are reporting, a state agency may ask for various types of evidence.
    • If you are reporting income falsification, you will want the employer's name and address, the type of income, when the income started coming in, and how often the person is paid.[19]
    • When reporting hidden assets, you will want to provide the bank's name and address where the hidden assets are located, or potentially the address of a piece of property if that is what is being hidden.[19]
    • For unreported family compositions, try to gather the name of the individual who moved in or out, when the move took place, the relationship of the individual to the case, and the approximate age of the individual.[19]
  3. Identify the intent of the welfare recipient. Before reporting potential welfare fraud, consider the suspect's intent. Is the person intending to defraud the government and receive improper benefits? Is the person acting knowingly? Could it be that the person is making an honest mistake?
    • Think about these questions before you submit a formal report. While it may not be possible to ascertain the individual's intent behind their actions, try to answer these types of questions as best as possible.
  4. Ask yourself why you are preparing to report welfare fraud. Before you start the reporting process, you should think about why you are considering reporting possible welfare fraud. Welfare fraud is often a criminal offense, meaning if someone is found to be engaged in fraud, they could be sent to prison.[20] You should be careful to only report suspected welfare fraud if you truly believe the person you are reporting has committed fraud. Most often, these reports are made by family members or former family members. Making false or baseless reports for the purpose of retribution or emotional distress can lead to you being criminally investigated for false reporting.[20]
  5. Assess the strength of your welfare fraud evidence. Before starting the reporting process, decide whether you have enough information to file an official fraud report. You should also assess the evidence and information you have gathered to make sure it constitutes fraud. Failing to do these things could cause an individual or family immense pain and suffering, and may open you up to a criminal investigation for false reporting.
    • If you file a report with little evidence, the report may not be followed up on by the state agency or the agency may not be able to determine if fraud occurred. If this happens, all of your hard work may go to waste. If you wait until you have a stronger case, your report may be taken more seriously and it may result in the state agency rightfully withdrawing welfare benefits from an individual or family taking advantage of them.
    • Also, if you file a welfare fraud report with little evidence, or evidence that does not constitute fraud, you may cause an individual or family to lose much needed financial support. While they may be able to get it back, the process will inevitably take time and may cause the individual or family a lot of unneeded stress.

Reporting Welfare Fraud

  1. Locate the correct agency or bureau. Go online to find the contact information of the agency in charge in your state.[20] Some states have an online reporting system, while others may require you to call or send an email detailing the potential fraud. Look carefully at the list provided in order to understand how you have to proceed. In most cases, the fraud report needs to be filed in the state where the fraud suspect lives and where the fraud has occurred.[20]
    • For example, New York and California have online fraud reporting.[21]
    • On the other hand, a state like Oklahoma provides a hotline number you can call.[20]
  2. Find out how to file your report. Each program will have different ways to report potential fraudulent activity. Some programs, for example SNAP, allow you to report fraud to the federal agency in charge.[22] Other programs, for example unemployment insurance, require you to report the potential fraud to the state agency in charge.[23] Once you have found out how to contact your state's welfare fraud reporting system, you should contact them and submit your report. In general, the information each state will ask you will be similar depending on the type of fraud you are reporting.
    • For example, in New York, the online welfare reporting system will ask you for the client's information (the person you are reporting about), which includes the person's name, address, social security number, phone number, and birth date.[21] It will then ask you for information about the allegation you are making, which will include a case number if you have one, the county where the person is receiving benefits, the type of benefits they are receiving, and the evidence you have to support your claim.[21] This is where you will detail all of the evidence you have gathered prior to making the report. Finally, the New York report asks you for your personal information, although it is optional.[21] your personal information will be used in case the state agency has any follow up questions or clarifications.[21] You should provide your personal information if you feel comfortable in order to allow the state agency to do the best work possible.
  3. Determine what needs to accompany your report. Some reporting systems may require you to send in documentation of the alleged fraud along with your official report. Check with your state or federal agency to see exactly what can be sent in. For example, see if you can send in audio or video files, paper records, or anything else you may think would be helpful.
    • In general, you should be able to report fraud anonymously and your identity will be protected under federal law.[22] Before you file a report, check with the agency you are reporting to to ensure your identity will be protected.
  4. Visit the Public Assistance Reporting Information System (PARIS) website to report multi-state welfare fraud. If the fraud you are looking to report involves an individual or family taking advantage of welfare benefits in two or more states, you should utilize the PARIS website. This website will provide you with a database of welfare recipients, which you can then look at to decide whether an individual is receiving benefits in multiple states.[24] In order to file this type of report, look at the PARIS contact information here and contact the applicable representative in order to start the process.
  5. Be accessible in case someone needs to follow-up. After you file your fraud report, make sure you remain available in case anyone at the applicable agency has any follow-up questions. There is a possibility that you may be interviewed later. In some circumstances, you may even be asked to testify in open court regarding your report.

Tips

  • It is important to write down details of fraudulent activity right after they happen. Memories can change over time. Create a journal and date your entries if you see suspicious activity.
  • Remember that you may not know all of the details of a family’s situation, and activities or situations that may seem like evidence of welfare fraud may have other explanations.
  • Some states offer monetary rewards to individuals who stop significant welfare fraud.[25]

Warnings

  • Do not attempt to stop welfare fraud yourself. Always report it to your local agency.
  • Maliciously reporting fraud that does not exist to make someone’s life uncomfortable may leave you open to criminal investigation.[20] Do not use fraud reporting for any kind of personal retribution.[20]

Related Articles

Sources and Citations

  1. ↑ 1.0 1.1 https://www.medicare.gov/Pubs/pdf/11306.pdf
  2. ↑ https://www.healthcare.gov/medicaid-chip/getting-medicaid-chip/
  3. ↑ https://www.medicare.gov/eligibilitypremiumcalc/#eligibility
  4. ↑ http://kff.org/medicare/state-indicator/total-medicare-beneficiaries/
  5. ↑ http://www.medicaid.gov/medicaid-chip-program-information/by-topics/eligibility/eligibility.html
  6. ↑ http://www.insurancefraud.org/statistics.htm#.VigzF6LwM-8
  7. ↑ http://www.fns.usda.gov/snap/supplemental-nutrition-assistance-program-snap
  8. ↑ http://www.fns.usda.gov/snap/eligibility
  9. ↑ http://www.snaptohealth.org/snap/snap-frequently-asked-questions/#howmany
  10. ↑ http://www.snaptohealth.org/snap/snap-frequently-asked-questions/#fraud
  11. ↑ http://www.theatlantic.com/politics/archive/2013/08/just-how-wrong-is-conventional-wisdom-about-government-fraud/278690/
  12. ↑ http://www.dol.gov/dol/topic/unemployment-insurance/
  13. ↑ http://www.huffingtonpost.com/2015/03/13/unemployment-benefits-rate_n_6832552.html
  14. ↑ http://www.huffingtonpost.com/2013/04/28/fraudulent-unemployment-benefits_n_3175092.html
  15. ↑ 15.0 15.1 https://www.ssa.gov/disability/
  16. ↑ https://www.americanprogress.org/issues/poverty/report/2013/05/30/64681/the-facts-on-social-security-disability-insurance-and-supplemental-security-income-for-workers-with-disabilities/
  17. ↑ http://thehill.com/blogs/congress-blog/economy-budget/195559-social-secuity-disability-fraud-is-rare
  18. ↑ http://fraud.laws.com/welfare-fraud
  19. ↑ 19.0 19.1 19.2 https://otda.ny.gov/resources/welfare-fraud/
  20. ↑ 20.0 20.1 20.2 20.3 20.4 20.5 20.6 https://www.ucowf.net/index.php?option=com_content&view=article&id=107&Itemid=65
  21. ↑ 21.0 21.1 21.2 21.3 21.4 https://reportwelfarefraud.otda.ny.gov/
  22. ↑ 22.0 22.1 http://www.fns.usda.gov/sites/default/files/SNAP_fraud_poster_press_0214.pdf
  23. ↑ http://www.dol.gov/dol/maps/fraud.htm
  24. ↑ http://www.acf.hhs.gov/programs/paris
  25. ↑ http://www.myflfamilies.com/service-programs/public-benefits-integrity/reward
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