leap fraud prevention and detection
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Report Fraud 1-877-934-6361 1
LEAP Fraud Prevention and DetectionColorado Department of Human Services
Report Fraud 1-877-934-6361 2
Update Topics
• Introduction
• Data Mining
• Fraud Detection
• Annual Data Mining Techniques
• Continuous Monitoring
• LEAP Fraud Example
• What Your State Can Do to Prevent Fraud
• Fraud Hotline
Report Fraud 1-877-934-6361 3
CDHS Audit Division
• Introduction to CDHS Audit Division
Report Fraud 1-877-934-6361 4
Data Mining
Filtering data to locate information or patterns of information
Report Fraud 1-877-934-6361 5
Fraud Detection
• Use data mining techniques to detect fraud and abuse
Report Fraud 1-877-934-6361 6
Annual Data Mining Techniques
• Our office analyzes the data from each year’s LEAP season
• We identify:
• Training issues
• Areas that may need rule or policy changes
• Possible misuse of LEAP funds
Report Fraud 1-877-934-6361 7
Annual Data Mining Techniques
• Search for fields in the data that are blank
• Identify duplicate entries in the SSN, household number, and address fields
• Review data for obvious data entry errors
Report Fraud 1-877-934-6361 8
Annual Data Mining Techniques
• Perform data matches to the Social Security Administration’s death records
• Group like counties together to perform data mining analysis tests on benefit issuance data
Report Fraud 1-877-934-6361 9
Annual Data Mining Techniquestech_number Count Percent of Count
1 32 0.91%2 219 6.22%3 284 8.06%4 5 0.14%5 291 8.26%6 176 5%7 306 8.69%8 167 4.74%9 299 8.49%
10 466 13.23%11 197 5.59%12 303 8.60%13 312 8.86%14 196 5.56%15 265 7.52%16 2 0.06%17 1 0.03%18 2 0.06%
Totals 3,523 100%
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Annual Data Mining Techniques
Number Total AverageRange - 600 -
Positive 466 114,313 245Negative 0 0 0
Zeros 0 - -Totals 466 114,313 245
Abs Value - 114,313 -
Highest Lowest700 100700 100700 100700 100700 100
NUMERIC10
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Annual Data Mining Techniques
NUMERIC10 CountPercent of Count
Percent of Field
NUMERIC10
100 - 159 210 45.06% 19.67% 22,488160 - 219 50 10.73% 8.25% 9,431220 - 279 30 6.44% 6.36% 7,265280 - 339 43 9.23% 11.55% 13,198340 - 399 38 8.15% 12.11% 13,840400 - 459 37 7.94% 13.89% 15,875460 - 519 26 5.58% 10.99% 12,564520 - 579 13 2.79% 6.24% 7,137580 - 639 6 1.29% 3.23% 3,698640 - 700 13 2.79% 7.71% 8,817Totals 466 100% 100% 114,313
Report Fraud 1-877-934-6361 12
Annual Data Mining Techniques
Report Fraud 1-877-934-6361 13
Continuous Monitoring
• CEPS (LEAP System Reports)
• EBT Card Withdrawal Reports
• State Financial System Reports
Report Fraud 1-877-934-6361 14
LEAP Fraud Example
• LEAP lead worker issued LEAP benefits to relatives
• Results - 3 years probation, 100 hours community service, and restitution and court costs
• Conflict of interest in this county
Annual LEAP Fraud Prevention Training
• Fraud Investigations
• Results
• Monitoring
Report Fraud 1-877-934-6361 15
Other Fraud Prevention Ideas
• Review system controls
• Ensure proper separation of duties are in place
• Rotate caseloads during the LEAP season
• Create interfaces between systems or perform data matches between systems
Report Fraud 1-877-934-6361 16
Report Fraud 1-877-934-6361 17
What Your State Can Do to Prevent Fraud
• Have in-depth discussions with your managers on how fraud could occur in your State
• Review and walk through internal controls
• Ask whether they are effective
• Address risk, make changes
• Ask for your county’s EBT card control procedures
• Ask whether they are effective
Report Fraud 1-877-934-6361 18
What Your State Can Do to Prevent Fraud
• Remind staff to be a prudent person when making eligibility decisions
• Use common sense
• Use program knowledge
• Make use of your rules and regulations
• Make use of experience and expertise
• Document the rationale you used to make the eligibility decision
Report Fraud 1-877-934-6361 19
Report Fraud 1-877-934-6361 20
Contact Information
• CDHS Audit Division
• Ryan Rivera, Audit Supervisor
• (303) 866-7329
• ryan.rivera@state.co.us • CDHS Low-Income Energy Assistance Program
• Todd Jorgensen, Director
• (303) 861-0325
• todd.jorgensen@state.co.us
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