Balancing Anti-Fraud Efforts and Due Process in Indiana

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Presentation transcript:

Balancing Anti-Fraud Efforts and Due Process in Indiana OCTOBER 2016 Balancing Anti-Fraud Efforts and Due Process in Indiana Kate Shelby Unemployment Insurance Director State of Indiana

Indiana Program Performance 2014 Improper Payment Rate: 14.02% Benefit Fraud Rate: 1.26% Overpayment Detection Rate: 48.45% Overall First Pay: 67.8% Separation Determination Quality: 67.39% Non-Separation Determination Quality: 46.81%

Due Process in Action Benefit determinations often involve three parties We cannot force employers to respond timely or at all “When due” means we have a time limit on initial determinations We cannot wait forever for parties to respond We must make a decision on the best available information “When due” means we have a very restricted time limit on continued claims determinations Decisions must be issued within 7 days We cannot stop benefits while investigating issues on continued claims Data and information lag times Data for important crossmatches is not provided in real time

Plan of Attack Fix Adjudication quality. Hire more adjudicators to meet first pay. Assess existing fraud prevention, detection, and recovery measures. Implement additional measures, as needed.

Existing Anti-Fraud Measures SSA verification: real time Fictitious Employer and Claims Data Analysis State Directory of New Hires State Employee Records crossmatch Claimant wage records crossmatch State tax return interception Prosecution program

Changes and New Programs Pay and Chase Programs Expanded and Automated State and National New Hire Directory Crossmatch Jobs for Hoosiers Program Automated wage records crossmatch Death Records Index Crossmatch Close to “Real Time” Programs IP Address Tracking Data Analysis and Match Program BMV identity verification Automated Workflow Deterrence Programs TOP Administrative Wage Garnishment

Indiana Program Performance 2014 Improper Payment Rate: 14.02% Benefit Fraud Rate: 1.26% Overpayment Detection Rate: 48.45% Overall First Pay: 67.8% Today Improper Payment Rate: 9.71% Benefit Fraud Rate: 0.37% Overpayment Detection Rate: 93.55% Overall First Pay: 91%

Issues That Will Remain As Long As States Must Pay Under Current “When Due” Rules: Pay and Chase BYE errors Data Lag Scarcity of Resources