OIG recovers more than $22.3 million in benefit overpayments during third quarter

The OIG’s Benefits Program Integrity (BPI) unit completed 3,459 investigations involving some form of benefit recipient overpayment or fraud allegation in the third quarter of fiscal year 2023. These efforts led to $22,315,452 in recoveries, 14 cases referred for prosecution and 213 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.

One case of note involved a Hamlin, Texas man who pleaded guilty in district court to securing the execution of a document by deception. The conviction results from an investigation conducted by the OIG and assisted by the United States Department of Housing and Urban Development, Office of Inspector General.

The individual applied to receive SNAP benefits, Medicaid benefits and housing assistance. Eligibility for SNAP, Medicaid and housing assistance is tied to household resources. Therefore, applicants are legally required to provide truthful information regarding income, financial resources and household composition.

In his application, the defendant claimed under penalty of perjury that the household’s income was limited to himself as an employee of a local business and that his earnings were only $225 per month. OIG investigators uncovered evidence proving the subject was an employee of the stated business and the business owner. The business’s financial documents were obtained, and verified the subject earned considerably more than the reported amount. The defendant obtained $9,674 in SNAP benefits, $15,726 in Medicaid benefits, and $27,811 in housing assistance he was not entitled to.

On April 4, 2023, the defendant was sentenced to 10 years’ probation, signed a 12-month SNAP disqualification and was ordered to pay full restitution to Texas Health and Human Services and the U.S. Department of Housing and Urban Development.