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LEAP Fraud Prevention and Detection

LEAP Fraud Prevention and Detection. Colorado Department of Human Services. Introduction Data Mining Fraud Detection Annual Data Mining Techniques Continuous Monitoring. LEAP Fraud Example What Your State Can Do to Prevent Fraud Fraud Hotline. Update Topics. CDHS Audit Division.

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LEAP Fraud Prevention and Detection

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  1. LEAP Fraud Prevention and Detection Colorado Department of Human Services Report Fraud 1-877-934-6361

  2. Introduction Data Mining Fraud Detection Annual Data Mining Techniques Continuous Monitoring LEAP Fraud Example What Your State Can Do to Prevent Fraud Fraud Hotline Update Topics Report Fraud 1-877-934-6361

  3. CDHS Audit Division • Introduction to CDHS Audit Division Report Fraud 1-877-934-6361

  4. Data Mining Filtering data to locate information or patterns of information Report Fraud 1-877-934-6361

  5. Fraud Detection • Use data mining techniques to detect fraud and abuse Report Fraud 1-877-934-6361

  6. Annual Data Mining Techniques • Our office analyzes the data from each year’s LEAP season • We identify: • Training issues • Areas that may need rule or policy changes • Possible misuse of LEAP funds Report Fraud 1-877-934-6361

  7. Annual Data Mining Techniques • Search for fields in the data that are blank • Identify duplicate entries in the SSN, household number, and address fields • Review data for obvious data entry errors Report Fraud 1-877-934-6361

  8. Annual Data Mining Techniques • Perform data matches to the Social Security Administration’s death records • Group like counties together to perform data mining analysis tests on benefit issuance data Report Fraud 1-877-934-6361

  9. Annual Data Mining Techniques Report Fraud 1-877-934-6361

  10. Annual Data Mining Techniques Report Fraud 1-877-934-6361

  11. Annual Data Mining Techniques Report Fraud 1-877-934-6361

  12. Annual Data Mining Techniques Report Fraud 1-877-934-6361

  13. Continuous Monitoring • CEPS (LEAP System Reports) • EBT Card Withdrawal Reports • State Financial System Reports Report Fraud 1-877-934-6361

  14. LEAP Fraud Example • LEAP lead worker issued LEAP benefits to relatives • Results - 3 years probation, 100 hours community service, and restitution and court costs • Conflict of interest in this county Report Fraud 1-877-934-6361

  15. Annual LEAP Fraud Prevention Training • Fraud Investigations • Results • Monitoring Report Fraud 1-877-934-6361

  16. Other Fraud Prevention Ideas • Review system controls • Ensure proper separation of duties are in place • Rotate caseloads during the LEAP season • Create interfaces between systems or perform data matches between systems Report Fraud 1-877-934-6361

  17. Have in-depth discussions with your managers on how fraud could occur in your State Review and walk through internal controls Ask whether they are effective Address risk, make changes Ask for your county’s EBT card control procedures Ask whether they are effective What Your State Can Do to Prevent Fraud Report Fraud 1-877-934-6361

  18. Remind staff to be a prudent person when making eligibility decisions Use common sense Use program knowledge Make use of your rules and regulations Make use of experience and expertise Document the rationale you used to make the eligibility decision What Your State Can Do to Prevent Fraud Report Fraud 1-877-934-6361

  19. Report Fraud 1-877-934-6361

  20. CDHS Audit Division Ryan Rivera, Audit Supervisor (303) 866-7329 ryan.rivera@state.co.us Contact Information • CDHS Low-Income Energy Assistance Program • Todd Jorgensen, Director • (303) 861-0325 • todd.jorgensen@state.co.us Report Fraud 1-877-934-6361

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