Bureau of Fraud Prevention and Prosecution
The Bureau of Fraud Prevention and Prosecution (BFPP) is responsible for conducting investigations into suspected public benefits fraud and abuse as well as performing collection activities for public benefit programs administered by the Pennsylvania Department of Human Services (DHS). BFPP is present throughout Pennsylvania based in four regional offices and headquarters office, which work in partnership with DHS County Assistance and District Offices to ensure that public benefits are distributed fairly and equitably. DHS benefit programs investigated by BFPP include: the Supplemental Nutrition Assistance Program (SNAP, formerly Food Stamps), Cash Assistance, Low Income Heating and Energy Assistance Program (LIHEAP), Medical Assistance (including Nursing Facility/Long Term Care), Subsidized Child Care.
Public Benefits Fraud Detection and Prevention
Field Investigation Program
The mission of the Field Investigation Program is to detect and prevent public benefits fraud by conducting investigations on applicants and recipients of public benefits to ensure the integrity of DHS benefit programs.
How does this occur?
Investigations in the Field Investigation Program can be initiated by DHS, the citizens of Pennsylvania, or through BFPP’s own processes. These referrals identify an applicant or recipient of public benefits who are suspected of providing inaccurate, inconsistent, or incomplete information to DHS. Persons receiving public benefits must disclose true and correct information regarding income, resources, residence, and household composition to DHS in order to accurately determine eligibility for public benefits. Individuals who apply for or who are receiving public benefits are informed by DHS that the OSIG can investigate their circumstances to ensure correctness.
The purpose of the field investigations performed by BFPP is to correctly determine the circumstances of the individual applying for or receiving public benefits. Once the investigation is completed, BFPP will provide the results to the DHS caseworker, who then uses the information provided to determine the individual’s eligibility for DHS benefit programs. The caseworker determines whether to authorize the individual for benefits, reduce the amount of benefits the individual is eligible for, or deny benefits to the individual.
Why is this important to the citizens of Pennsylvania?
BFPP’s Field Investigation Program is a system of checks and balances that helps ensure the integrity of public benefits programs in Pennsylvania. Its efforts yield millions of dollars in cost savings annually to DHS and the citizens of Pennsylvania.
Fraud Investigation Program
BFPP operates its Fraud Investigation Program with the mission of investigating and prosecuting individuals who fraudulently received public benefits to which they were not entitled. Pennsylvania law prohibits the fraudulent receipt of benefits and individuals who commit public benefits fraud face criminal charges, costs and fines, mandatory restitution of the illegally received public funds, and disqualification from receiving future benefits.
What is public benefits (“welfare”) fraud?
Individuals receiving public benefits must provide true and correct information regarding income, resources, residence, and household composition to DHS.
Welfare fraud occurs when:
- An individual provides false information about their circumstances or fails to report a change in those circumstances.
- The individual failed to provide true and correct information to DHS with the intention of receiving benefits they wouldn’t have been entitled to had DHS known their true circumstances.
- An individual is also guilty of welfare fraud if they aid or abet another person who receives benefits through fraudulent means.
How is welfare fraud discovered?
Welfare fraud can be discovered in many different ways, which can include:
- Tips received from Pennsylvania citizens that uncover individual(s) committing public benefits fraud.
- DHS computer system matches, which can identify unreported information, such as employment.
- BFPP Field Investigations which uncover information that was not reported to DHS and resulted in public benefits fraud.
When DHS receives information that a public benefits recipient failed to report information that affected their past eligibility for benefits, a DHS caseworker will calculate the amount of overpaid benefits received by the individual and forward that information to BFPP for investigation. BFPP staff will conduct an investigation to determine if the individual in question in fact committed welfare fraud. If welfare fraud occurred, BFPP staff will work with the local district attorney to file criminal charges of public benefits fraud against the individual. Once welfare fraud charges are filed, the case will move through the Commonwealth’s court system.
Why is this important to the citizens of Pennsylvania?
The prosecution of welfare fraud in Pennsylvania serves taxpayers by:
Ensuring that individuals who commit these acts are held accountable and that fraudulently received benefits are repaid to the Commonwealth,
- Ensuring program integrity in DHS benefit programs,
- Providing a deterrent to individuals who may consider committing welfare fraud cases where individual are found guilty of committing criminal welfare fraud are publicized,
- Disqualifying individuals convicted of welfare fraud from receiving future benefits for a period of time, up to a permanent disqualification, which saves the Commonwealth additional expenditures,
- Recovering millions of dollars annually of public funds.
Supplemental Nutrition Assistance Program (SNAP) Trafficking Unit
What is SNAP Trafficking?
SNAP Trafficking occurs when SNAP benefits (formerly known as Food Stamps) are illegally exchanged for cash, services, or anything other than food. For example, a store owner may give a SNAP recipient cash at a percentage of their balance in SNAP benefits, or exchange SNAP benefits for drugs or other non-allowable goods such as cigarettes. BFPP operates its SNAP Trafficking Unit with the mission of investigating instances of this type of fraud when it occurs in Pennsylvania. This unit works with the U.S. Department of Agriculture’s (USDA) Food and Nutrition Services (FNS) and with the USDA Office of Inspector General to investigate cases of SNAP trafficking.
The official definition of SNAP Trafficking is: (1) The buying, selling, stealing, or otherwise effecting an exchange of SNAP benefits issued and accessed via Electronic Benefit Transfer (EBT) cards, card numbers and personal identification numbers (PINs), or by manual voucher and signature, for cash or consideration other than eligible food, either directly, indirectly, in complicity or collusion with others, or acting alone; (2) The exchange of firearms, ammunition, explosives, or controlled substances, as defined in section 802 of title 21, United (3) Purchasing a product with SNAP benefits that has a container requiring a return deposit with the intent of obtaining cash by discarding the product and returning the container for the deposit amount, intentionally discarding the product, and intentionally returning the container for the deposit amount; (4) Purchasing a product with SNAP benefits with the intent of obtaining cash or consideration other than eligible food by reselling the product, and subsequently intentionally reselling the product purchased with SNAP benefits in exchange for cash or consideration other than eligible food; or (5) Intentionally purchasing products originally purchased with SNAP benefits in exchange for cash or consideration other than eligible food.
How does BFPP investigate this?
BFPP’s SNAP Trafficking Unit conducts SNAP Electronic Benefits Transfer (EBT) card trafficking investigations of both store owners and SNAP recipients. Store owners will be disqualified from participating as a SNAP approved vendor and recipients who are found to have trafficked their SNAP benefits must repay those benefits and are disqualified from receiving SNAP benefits.
Why is this important to the citizens of Pennsylvania?
SNAP Trafficking is happening in big cities and small towns alike throughout the Commonwealth. Through the concerted efforts of the federal government and the Pennsylvania OSIG, individuals who engage in SNAP Trafficking are being held accountable.
Penalties can include:
- Federal or state criminal charges,
- Lifetime disqualifications from receiving SNAP benefits,
- Mandatory repayment of trafficked benefits,
- The store owner’s disqualification from participation in SNAP.
Further, SNAP Trafficking is not always a stand-alone crime. Often these stores are also dealing in illegal drugs which further pollute communities. SNAP Trafficking undermines the true purpose of the program, which is to feed impoverished families.
Collections Program
Individuals who are prosecuted for public benefits fraud will be ordered to make restitution to the OSIG. However, not all overpayments referred to the OSIG meet the elements of welfare fraud. Regulations state that all incorrectly paid benefits, regardless of whether or not fraud occurred, must be repaid to the Commonwealth. All DHS overpayments are collected by the OSIG. The OSIG uses the following methods to collect all overpaid benefits:
- Recoupment – this occurs when an individual or their household is currently receiving public assistance. The amount of their monthly benefit is reduced to repay the overpayment.
- Repayment – an individual makes a direct payment to the OSIG to repay their overpayment.
- Third Party Debt Collection – through the Office of Attorney General, all delinquent, non-SNAP debts are forwarded through a tiered private collection process to effect repayment of monies owed to the Commonwealth.
- Treasury Offset Program (TOP) – this option is available on SNAP overpayment claims. Individuals who have not made a payment for at least 180 days and have a claim balance of $25 or more can be entered into TOP. Once in this program, the individual’s federal income tax refund, as well as other forms of federal income, can be intercepted to repay the balance of their claim.
Another collections program run by the OSIG is the Reimbursement Program. Individuals who are awaiting the receipt of other benefits, such as unemployment compensation or Supplemental Security Income, may be found eligible to receive cash assistance pending approval of these other benefits. Once the individual receives their benefits, they are required to reimburse the Commonwealth for the cash assistance they received from DHS.