MM Curator summary
The article below has been highlighted and summarized by our research team. It is provided here for member convenience as part of our Curator service.
[MM Curator Summary]: Don’t let anyone tell you member fraud is not real. This article is about $6.2M in recoveries (so probably 10x that in losses) for just one quarter.
Clipped from: https://oig.hhs.texas.gov/about-us/news/62-million-benefit-overpayments-recovered-during-first-quarter-fiscal-year
The OIG’s Benefits Program Integrity (BPI) unit completed 3,205 investigations involving some form of benefit recipient overpayment or fraud allegation in the first quarter of fiscal year 2023. These efforts led to $6,255,879 in recoveries, 5 cases referred for prosecution and 187 cases referred for administrative disqualification.
Most completed investigations involved applicants misrepresenting the number of income-earning household members. Programs like the Supplemental Nutrition Assistance Program (SNAP), Medicaid and others use household composition and income to determine a client’s eligibility for assistance and the proper benefit amount. Below is a selection of SNAP fraud cases involving program clients.
Dallas SNAP client pleads guilty to fraud
In September, a Dallas woman pleaded guilty in Texas District Court on charges of illegal possession of Supplemental Nutritional Assistance Program (SNAP) benefits. The charges stemmed from an investigation by the OIG.
The 1996 Federal Welfare Reform Act requires states to permanently disqualify individuals from the SNAP program if they have a felony drug conviction for conduct occurring after August 22, 1996. Applicants must provide truthful information to the state and notify the State of any past felony drug convictions during the application process.
The individual in question applied for SNAP benefits on January 31, 2011, and claimed under penalty of perjury that she had no such felony drug convictions. However, OIG investigators uncovered evidence that she was convicted of Unlawful Possession of a Controlled Substance, a state jail felony, on April 15, 2004.
The investigation showed that from January 2011 through November 2012, the defendant failed to disclose the conviction on five separate applications for SNAP benefits, receiving $9,252 in excess benefits. As a result, she was sentenced to three days in county jail and permanently disqualified from the SNAP program.
Olney woman convicted for SNAP fraud
A woman in Olney was found guilty in an administrative hearing of committing an Intentional Program Violation. The verdict is the result of an investigation by the OIG.
The individual applied to receive SNAP benefits on October 20, 2017. Because eligibility is tied to household resources, applicants must provide truthful information to the state and notify the state if their household’s composition or income changes.
In her application, the defendant claimed under penalty of perjury that the household consisted of only herself and two children. However, OIG investigators uncovered evidence that the children’s father was, in fact, living in the home and receiving income from a full-time job.
The investigation revealed that over more than four years, the perpetrator received $21,148 in excess benefits because of the fraudulent, unreported information. As a result, she was disqualified from the SNAP program for 12 months and ordered to pay full restitution.
Hidalgo County SNAP and Medicaid client pleads guilty to theft
A Hidalgo County resident pleaded guilty to felony theft after an investigation by the OIG.
The individual applied to receive SNAP benefits on August 19, 2015. In her application, the defendant claimed that the household’s income was from her employment. However, OIG investigators found that the defendant had consistent U.S. currency deposits into her and her husband’s joint bank account that she did not report during the application process. Had she truthfully disclosed the household income, her benefits would have been drastically reduced since household resources determine eligibility.
The defendant continued to falsely report the household income for almost four years, from August 2015 through May 2019. In total, the defendant obtained $20,397 in SNAP benefits and $11,514 in Medicaid benefits she was not entitled to receive.
In September 2022, she was sentenced to 10 years of probation and ordered to pay $31,911 in restitution to Texas Health and Human Services.