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Fraud Investigations

The Investigation Unit consists of several programs which function to ensure program integrity and the eligibility of Social Services customers.

How and Where to Report Suspected Fraud
The Investigation Unit is located at 797 Broadway, Schenectady, New York.  Allegations of suspected fraud may be directed to this address in writing or in person or can be reported to (518) 388-4489.  All reports of suspected fraud are kept confidential.

The Front End Detection (FEDS) Program
The FEDS Investigators conduct investigations, home visits and office interviews on applications f or cash assistance, including those from families, single adults or married couples.

Allegations of Fraud
Fraud referrals are received from agency staff and members of the community.  When an investigation is completed, the evidence package is sent to the District Attorney’s Office for review and prosecution.  Improper conduct that does not meet the threshold set by DSS and the DA’s Office may result in recoupments of overpayments through grant reduction, judgments or disqualifications.

Intentional Program Violations
When the result of an investigation does not meet the standard to prosecute a case criminally, this administrative law process provides a means to obtain repayment and disqualifications for benefits improperly received.  The Investigation Unit staff matches the local police blotter arrestees against the Social Services recipient population daily.  Individuals arrested for “income producing” crimes and receive benefits are disqualified upon a plea of guilty or being found guilty, from respective the programs for not reporting the illegal income they obtained.

Food Stamp Claims
Every incorrect issuance of Food Stamps must be evaluated as to cause and a repayment must be pursued if appropriate.  Repayment is made for fraud, client error and agency errors.  Payments may be the result of recoupments against future benefits, made voluntarily or may result from a federal offset against a tax refund.

Federal and State Matches
Federal and State databases provide information which must be investigated.  A criminal justice database provides information on customers that may have outstanding criminal warrants for arrest.  Until the warrant is satisfied, the customer is ineligible for public assistance benefits.  Coordination exists with all levels of law enforcement to ensure the timely closing or denial of ineligible cases.  Various states participate in a shared database which identifies potential duplicate assistance to a family or individual.  This process includes cases for cash assistance, Food Stamps and Medical Assistance.

How to report suspected provider or recipient Medicaid Fraud:
If you or someone you know is aware of fraudulent Medicaid billing practices these allegations can be reported to the number listed above.  You can also report provider fraud by calling:

New York State Office of the Attorney General
New York State Department of Health - Office of Medicaid Fraud & Abuse
New York State Office of the Welfare Inspector General