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Fraud and Abuse Prevention team targets welfare abuse

Governor Paul LePage and Attorney General William J. Schneider have announced that officials from the Maine Department of Health and Human Services (DHHS) and the Office of the Attorney General are intensifying their focus on preventing and prosecuting fraud and abuse in public assistance programs.

A Fraud and Abuse Prevention Team has been formed to analyze current systems and existing resources available within state government to deter fraud before it happens and to assure that all illegal activities within Medicaid, Food Supplement, Temporary Assistance for Needy Families (TANF) and other programs are being properly investigated.

“People who receive benefits that they are not entitled to continue to drain existing resources that should be used for those who are truly in need,’’ said Governor LePage. “The work of this group reinforces the message that we take fraud and abuse very seriously and that those who abuse the system will face significant consequences.”

The nine-member team will focus on both recipient fraud and MaineCare provider fraud, with DHHS’s Division of Audit and Office for Family Independence working collaboratively with the Financial Crimes & Civil Rights Division of the Attorney General’s Office.

Current initiatives include strengthening the recipient fraud hotline in DHHS; improving the training for frontline staff to identify fraud; and reviewing federal and state laws that may make it difficult to remove recipients from benefit programs when they violate program rules.

From January 2010 to March 2011, prosecution of MaineCare provider fraud by the Attorney General’s Office resulted in six convictions, more than $4 million in restitution ordered and, in one case, 42 months of jail time for the perpetrator. During that time there were 15 civil fraud settlements with over $5 million in state dollars recovered.

It is critical that we strengthen our efforts to prevent and address fraud throughout the programs within the Department,’’ said DHHS Commissioner Mary Mayhew. “Our resources to help people in need are limited and we must ensure that those resources are being delivered and used appropriately.”

In the last several months, recipient fraud cases have resulted in harsher sentences, including a one-year sentence against a woman who received benefits by lying to DHHS about her household income. Since 2009 at least $207,000 restitution has been ordered in 14 successful convictions against individuals who fraudulently received public assistance benefits.

“This coordinated and proactive effort to investigate and prosecute fraud is a high priority and we will aggressively pursue those who steal from the system,” said Attorney General Schneider.

Schneider urged people who suspect recipient fraud to call the DHHS hotline at 1-800-442-6003. To report MaineCare provider fraud, call 287-4660 or email hcu.ag@maine.gov. Although the caller can remain anonymous, the name of the person or provider alleged to have committed the fraudulent act must be shared in order for the case to be investigated.

 

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