OIG recovers fraudulent benefits payments

The OIG Benefits Program Integrity (BPI) unit investigates allegations of overpayments to clients participating in the benefits programs administered by the Texas Health and Human Services Commission. 

BPI overseen programs include the Supplemental Nutrition Assistance Program (SNAP), Texas Temporary Assistance for Needy Families, Medicaid, Children's Health Insurance Program and the Special Supplemental Nutrition Program for Women, Infants and Children. In the second quarter of fiscal year 2022, BPI completed investigations of 4,375 cases, referring five investigations for prosecution and 108 investigations for administrative disqualification hearings. BPI recovered $5,604,952 in fraudulent benefits claims. A sample of recent completed cases include: 

BPI resolved a case in Hardin County where a client committed fraud by failing to report her children’s father as a member of her household when applying for SNAP and Medicaid benefits. From July 2017 to November 2019, the client received a total of $25,406 in excess benefits. To prove the father was a part of the client’s household and married to the client, the BPI investigator obtained photos of the husband’s car at the client’s residence along with records from numerous government agencies and multiple witness statements indicating the husband resided at the home. After evidence was presented to the Hardin County district attorney, the client was ordered to pay the full $25,406 in restitution and was disqualified from the SNAP program for ten years.

BPI presented investigative findings at an Administrative Disqualification Hearing regarding an authorized representative who renewed SNAP benefit applications on behalf of a client and attested that the client resided in their home; however, the client was incarcerated and ineligible to receive benefits. Authorized representatives are designated by a client to sign applications, complete and submit renewal forms, receive
notices, designate health plans, and otherwise act on behalf of the client. Authorized representatives are also required to follow program rules and are not permitted to use a client’s benefits for themselves. The hearing officer found the authorized representative committed an intentional program violation. The authorized representative was disqualified from SNAP for 12 months and required to pay $1,720. The investigation was the result of a data match with Texas Department of Criminal Justice records that compare individuals receiving benefits with incarceration records for the purpose of identifying potential fraud, waste and abuse.