Data tools help root out social services fraud
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Data modeling, analytics and visualizations are helping the Texas HHS inspector general detect and prevent fraud, waste and abuse within state programs.
The Texas Health and Human Services Department's inspector general is turning to data modeling and visualization tools to investigate Supplemental Nutrition Assistance Program (SNAP) cases with an increased risk of fraud.
Using funds from the SNAP Fraud Framework Implementation Grant, the Texas Office of Inspector General’s Benefits Program Integrity (BPI) division recently developed a data visualization dashboard that will help unit managers oversee high-volume investigative caseloads.
Dubbed the Work in Progress board, this tool “produces visualized data regarding the progress of milestones throughout the investigative lifecycle to help BPI leadership identify barriers and provide assistance when delays exist,” according to OIG’s Quarterly Report. Additionally, the board can help investigators gather intelligence for streamlining processes and allocating resources toward the most time- and resource-intensive tasks.
BPI is also working with industry partners on a data model and visualization tools that will help its investigators proactively identify cases with an increased risk of SNAP fraud. The partners are currently refining the data incorporated in the model, validating and weighting potential risk indicators and securing infrastructure support to promote sustainability, according to the OIG.
The office’s Data Initiative Project Team focuses on providers who may be receiving Medicaid payments that they are not entitled to. When OIG staff identify an issue with one provider, DIPT can analyze data from across the Texas health care system to determine whether similar issues are occurring with other Medicaid providers.
OIG has also contracted with analytics provider SAS to develop more advanced analytical tools to help identify potential indicators of fraud, waste and abuse throughout Texas Health and Human Services programs.
“DIPT's efforts have led to settlements totaling more than $48 million,” the report said. “By harnessing the power of data analytics and the expertise of OIG staff, investigators and attorneys, DIPT can handle cases in a more efficient manner from the moment a case is initiated to final resolution.”