BPI recovers $33 million in FY 2020

The Benefits Program Integrity (BPI) division completed more than 16,000 investigations involving some form of benefit recipient overpayment or fraud allegation in fiscal year 2020. The majority of investigations completed involved unreported income or an issue with the reported household composition. Household composition cases usually include an unreported household member who has income or could also include a reported household member who does not actually live in the same residence. Both instances cause the household to receive more benefits than they are eligible for.

For fiscal year 2020, BPI recovered $33.2 million, identified $56 million for recovery and realized $6.7 million in cost avoidance.

A sample of cases worked by BPI in the fourth quarter include:

Excessive benefits. BPI investigated a client in Bexar County who submitted falsified applications for SNAP and Medicaid benefits. From December 2013 to June 2018, the client concealed his and his wife’s income as business owners. As a result, the client received $94,510 in excess SNAP and Medicaid benefits. The case was presented to the Bexar County District Attorney’s Office for prosecution. The client pled no contest to the charge of third-degree theft-welfare fraud. In June, the client was sentenced to ten years deferred adjudication probation, ordered to pay full restitution, complete 100 hours of community service and attend an anti-theft program facilitated by Bexar County.

Falsifying benefits application. In July, BPI resolved a case in Smith County where a client failed to report her husband, the father of the client’s children, as part of her household. The BPI investigator verified through a variety of sources that the client’s husband lived in the household and had income. The case was submitted to the Smith County District Attorney. The client pled guilty to third-degree felony theft, received 10 years deferred adjudication probation and was ordered to pay $34,564 in restitution.

To read more about the OIG’s work to ensure the integrity of state health and human services, read the agency’s latest quarterly report.