SD11 - Welfare Fraud Study


Executive Summary:
A study was mandated by Senate Joint Resolution 356 which stated, "(t)he Secretary shall also study specific topics referred to it by the 1997 Session of the General Assembly, including Senate Joint Resolution No. 346 on welfare fraud." Senate Joint Resolution 356 required the Secretary to submit initial findings and recommendations to the Governor and the 1998 Session of the General Assembly by November 15, 1997. An initial report was completed and submitted on November 14, 1997. Senate Joint Resolution 356 also required the Secretary to submit subsequent findings and recommendations to the Governor and the 1999 Session of the General Assembly by November 15, 1998. This report represents the Secretary's subsequent findings and recommendations.

The Virginia Department of Social Services (VDSS) has oversight responsibility for all public assistance programs it administers to ensure that benefits and services go only to qualified recipients, in the correct amounts. The federal government holds the state accountable for program integrity and any related misspending.

Fraud occurs when applicants or recipients intentionally withhold information or provide false or incomplete information to obtain benefits and services. To control fraud, VDSS sets policy and provides resources, training, and assistance to its 122 local departments of social services.

It is the responsibility of local departments of social services to identify instances of fraud, take appropriate steps for either prosecution or administrative action, and recover fraudulent payments from recipients. Agencies must also identify other overpayment errors and seek reimbursement from recipients.

The 1998 General Assembly passed legislation which amended 63.1-58.2 of the Code of Virginia to mandate a statewide fraud control program. Prior to this legislation, local boards of social services were given statutory authority, but were not required, to establish fraud prevention and investigation units. The State Board of Social Services has promulgated regulations establishing the fraud control program policy and VDSS has established fraud control program procedures and staffing requirements.

This report provides an overview of VDSS' commitment to and current practices in the prevention, detection and investigation of welfare fraud, and the recovery of public assistance overpayments which result from the commission of fraud.