BPI recovers $3.9 million in fourth quarter
The Benefits Program Integrity (BPI) division completed 4,203 investigations involving some form of benefit recipient overpayment or fraud allegation in the fourth quarter of fiscal year 2020. Eighty-five percent of all 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.
BPI completed 235 investigations where fraud was determined. Investigators referred two investigations for prosecution and 233 for an administrative disqualification hearing. Ninety-two percent of fraud investigations completed involved either unreported income or an issue with the reported household composition.
In the fourth quarter, BPI recovered $3.9 million, identified $13.6 million for recovery and achieved $1.5 million in cost avoidance. For fiscal year 2020, BPI recovered $33.2 million, identified $56 million for recovery and realized $6.7 million in cost avoidance.
You can read about the cases settled and dollars recovered in the OIG’s latest Quarterly Report. https://oig.hhsc.texas.gov/sites/default/files/documents/oig-quarterly-report-q4-fy20-v2.pdf