Find the Fraud

ith an annual budget of almost $10 billion and as a provider of vital programs and services to one third of the state’s residents, the importance of the Department of Social and Health Services must never be taken for granted. DSHS serves one of the most critical functions of state government: helping needy and vulnerable adults and children in every community.

So when allegations of fraud arise, swift and effective action must be taken. DSHS officials take this responsibility seriously, last year recovering $20.6 million in Medicaid fraud, saving $381 million by identifying third-party insurers and recovering $48.7 million in client overpayments and other fraudulent benefits paid.

Still, more must be done. We agree with state Sen. Joe Zarelli, R-Ridgefield, who has called for an independent office to investigate new allegations of widespread fraud in DSHS. As Kathie Durbin reported in Wednesday’s Columbian, those allegations were made by state employees who responded to an e-mail request by the Senate Republican Caucus for solutions to the state’s overall budget woes. In a video on the caucus website, Zarelli said, “When we start looking at this and peeling back this onion, it’s very apparent to me that we can save millions of dollars by simply going back to an approach of investigating money … that is being spent, that is being collected in a fraudulent way.”

Granted, they’re only allegations, but the number (more than a dozen from DSHS employees) and the severity of the reports warrant the creation of an independent investigatory office as Zarelli recommends. A DSHS spokesman, Thomas Shapley, has said that the department has a good record of fraud investigation, and the savings described above support that contention. But the abundance of reports requires a more independent investigatory office.

Among the allegations were the widespread abuse of welfare assistance, food stamps, subsidized child care and medical assistance programs. Some clients allegedly apply for assistance by phone or the Web without verification of income or assets. Police are said to be routinely confiscating state-issued Electronic Benefit Transfer cards from arrested drug dealers. Another allegation is that a revolving door of clients receive welfare payments through the Temporary Assistance to Needy Families program for longer than the five-year limit. One e-mailer alleged that some families receive food stamps for children who don’t exist.

Shapley says that DSHS already is monitored by federal agencies, the State Auditor’s Office and the Joint Legislative Audit Review. He also notes that DSHS has reduced the size of its Division of Fraud Investigation. But if Zarelli is correct in his contention that millions more dollars can be saved, then creating a new independent investigatory office would be wise. And if Zarelli is incorrect, that new office could always be closed. We doubt that would be case because, if millions of dollars already are being recovered, it’s reasonable to assume more fraud is still out there. And the multiple allegations recently received strengthen that belief.

More than 2 million people, including about half of the state’s children and teens, rely upon DSHS for crucial assistance. Making the department as efficient as possible is the state’s obligation not only to those people, but to all state and federal taxpayers who help fund DSHS.

The department must not take lightly the findings of the “Reset Washington” process.