Fraud Referrals

Created on: 
Apr 22 2016

How does the Department address potential fraud?

Department eligibility staff may make an internal referral for fraud investigation when they become aware of facts that indicate an overpayment has occurred as a result of a client's intent to conceal or misrepresent facts to the Department.  All fraud referrals will be routed to the appropriate DSHS staff and unit.

If information provided by a client or provider is questionable, or if verification seems tampered with, inconsistent, or unconvincing, eligibility workers may refer their case to Fraud Early Detection (FRED).

FRED investigators search various systems and documents to determine a client’s situation. They may also conduct interviews with clients, neighbors, family members, landlords, and employers to resolve questions or inconsistencies.

After an investigation, investigators report their findings to eligibility staff. Staff then take appropriate action on the information, which may include, but is not limited to, terminating benefits, issuing overpayments, requesting additional verification, or updating systems to reflect the client’s situation accurately.