Enforcement Division is responsible for investigating instances of alleged recipient welfare fraud and benefits trafficking in all programs administered by MDHHS including the Food Assistance, Medicaid, cash, Child Daycare and State Disability Assistance programs. Enforcement Division also conducts investigations of non-Medicaid vendor fraud as well as department employees alleged to be involved in program fraud. All investigations found to contain the elements of fraud are forwarded to the appropriate prosecutorial authority for criminal disposition or are forwarded to the appropriate MDHHS program area for administrative action.
FIELDS OF INVESTIGATION:
Special Investigation Unit
The Office of Inspector General Special Investigation Unit (SIU) investigates the most complex criminal and civil complaints of fraud, waste and abuse in the programs administered by the Department. The SIU identifies and determines existence of sophisticated criminal conspiratorial schemes by employees, contractors, businesses, vendors and recipients to receive program funds.
Benefit Trafficking Unit
This unit investigates instances of public assistance trafficking in which individuals either attempt to traffic or actively traffic benefits by buying, selling or trading benefits for cash or ineligible items including: tobacco, alcohol, firearms, drugs and gambling. Violations of the Food Assistance Program occur when food assistance is redeemed for cash, offered for sale in person or on the internet or when unauthorized items are bought or sold.
Individuals who intentionally violate the Food Assistance Program are disqualified for a period of 12 months for the first offense, 24 months for the second offense and permanently for the third offense.
Some retailers violate the Food Assistance Program by accepting food assistance for cash at less than par value or for unauthorized items such as tobacco, alcohol, etc.
In Michigan, the Bridge Card is the only way to receive food assistance.
Medicaid assistance trafficking includes prescription forgery, prescription theft and narcotic shopping with multiple prescribers/pharmacies.
Recipient investigations conducted by the MDHHS Office of Inspector General (OIG) Enforcement Division cover all programs administered by MDHHS where the recipient (beneficiary) has received benefits as a result of fraudulent activity, or Intentional Program Violations. Recipient fraud typically constitutes unreported or improper representation of household circumstances causing an overpayment of public assistance benefits.
Traditional MDHHS programs investigated include:
Food Assistance Program (FAP)
Family Independence Program (FIP)
State Disability Assistance (SDA)
State Emergency Relief (SER)
Child Development & Care (CDC)