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Chapter 7: Workforce
Reduce Unemployment
Insurance Fraud
Summary
In 1996, Texas paid out more unemployment insurance benefits than all but six
other states. Despite this, the percentage of fraudulent overpayments identified
was well below the national average. While this could be the result of a strong
fraud deterrence system, it is more likely due to a lack of aggressive fraud
detection. Texas should adopt specific strategies used successfully by other
states to increase the identification and recovery of unemployment insurance
benefit overpayments.
Background
The unemployment insurance (UI) program uses state and federal dollars to
provide weekly cash benefits to Texas residents who are unemployed through no
fault of their own. Employers covered under the Texas Unemployment Compensation
Act report wages paid to their employees and pay taxes based on the number of
employees and amount of wages, as well as their past record of employee UI
claims. Employers also pay taxes under the Federal Unemployment Tax Act, which
finances state UI administrative agencies, state employment services, and the US
Department of Labor’s (DOL’s) Unemployment Insurance Service.
The Texas Workforce Commission (TWC), the entity that regulates the
state’s unemployment insurance payments, reports that in fiscal 1999,
approximately 749,000 unemployed workers filed claims. The state paid $1.2
billion in regular state UI benefits for qualified applicants, and around
382,000 employers paid UI taxes.[1]
The unemployment insurance system can be defrauded in a number of ways; these
include claiming UI while on vacation, using false Social Security numbers,
filing for UI while still employed, or continuing to collect UI even after
becoming re-employed. Other methods include fictitious employer schemes and the
use of illegal aliens to claim benefits in “kickback”
schemes.[2]
Unemployment fraud costs the nation millions of dollars each year. An
estimated$22 million in false UI claims were filed in New York in
1998.[3] Illinois compares a list of new hires
with people collecting UI to detect early fraud; in 1997, the state denied the
UI claims of 5,000 people.[4] Nebraska identified
600 fraudulent claims made by employees seeking UI in addition to their vacation
pay that would have cost the state $221,000.[5]
In 1999, Louisiana issued 32 warrants for suspects charged with stealing $81,000
from the UI program, only a fraction of the estimated $8.5 million in UI fraud
committed in the state between 1995 and 1999.[6]
A benefit overpayment occurs when an unemployed worker receives too much UI
money. Overpayments can take place because of accounting errors on the part of
the agency administering the payments, or because the person receiving the
benefits lied about his or her status and is receiving the benefits under false
pretenses. Once TWC knows an overpayment has been made, it must document it and
then try to recover the money.
According to a DOL national study, overpayment dollars recovered as a
percentage of benefits paid increased from 0.63 percent in 1984 to 1.19 percent
in 1995. Comparing overpayments collected to total benefits paid measures the
success of recoveries over time even as the fund grows. In other words, while
the amount of overypayments detected more than tripled from $174.6 million in
1984 to $601 million in 1995, the ratio of overpayments recovered to total
benefits paid only doubled. DOL concluded that studies to identify overpayment
patterns in specific industries and find weaknesses in prevention programs could
increase the amount of overpaid UI benefits
collected.[7]
Between 1994 and 1996, fraudulent overpayments detected in Texas averaged
$6.3 million, or 0.62 percent of total benefits, which is considerably lower
than the US average of 1.08 percent. Only 24.5 percent of Texas’
overpayments were due to fraud in 1995, compared to the US average of 44.2
percent.[8] By 1998, Texas’ ratio had risen
to 28.2 percent, but so had the US average (52.9
percent).[9] These percentages suggest that other
states are doing a considerably better job of detecting fraud than Texas.
Beginning in May 1998, the TWC opened seven “telecenters” to
process unemployment claims and updates over the telephone. Previously,
claimants picked up their UI benefit checks in person at a TWC office. According
to the Dallas Morning News, one of the reasons Texas converted to an
automated system for UI filing and payment was to free up resources to allow the
agency to investigate UI fraud more
aggressively.[10] TWC’s method of
deterring fraud in the new automated system is to play a message outlining the
consequences of providing the system with false statements. This same message is
printed on the back of UI benefit checks mailed to claimants, who, when they
endorse the checks, also are signing a pledge that all the information they have
provided to TWC regarding their UI claim is true.
Once TWC detects an overpayment, the agency contacts the recipient by mail
and telephone. If TWC determines that the overpayment is the result of fraud, it
files a “Notice of Assessment,” a legal document notifying the
claimant that he or she has 30 days to return the overpayment. According to TWC,
the Notice of Assessment holds the same power as a District Court’s
final judgement in a case. If the recipient does not return the overpayment
after 30 days, TWC files an “Abstract of Assessment” with the
claimant’s county clerk.[11] An Abstract
of Assessment serves as a lien against the claimant’s property and becomes
a part of the claimant’s credit record.
According to a report compiled by DOL’s Office of the Inspector
General, Texas had only 15 investigators working on fraud cases in October 1998,
and had not prosecuted any fraud cases since 1996. Texas has fewer investigators
than most states with systems of comparable size, including California (18
investigators), New York (52), Florida (20), Georgia (18), and New Jersey
(39).[12] Despite reductions in its UI staff
due to the automated functions of the new telecenters, TWC has not increased its
number of UI investigators. TWC states that the reason for this is the high cost
of the telecenter technology.
In November 1996, TWC changed the way it produced prosecution
“packets,” the collection of legal documents necessary to prosecute
a UI fraud case. The change inadvertently resulted in TWC’s inability to
generate the legal documents necessary to prosecute individuals for UI fraud.
Consequently, TWC stopped referring cases for prosecution.
In 2000, TWC moved to a personal computer-based system to allow them to do a
better job of producing the prosecution packets. One staff member is taking the
new packets to each of the 254 county prosecutors to encourage them to prosecute
UI fraud cases. Although TWC is authorized to pursue criminal charges on
fraudulent UI overpayments, the offense is a Class A misdemeanor regardless of
the amount of money involved.[13]
A 1995-96 DOL study identified 28 different UI fraud detection methods used
by states. Cross-matching UI wages with benefits paid accounted for 68% of the
fraud over-payments detected, but other methods, such as automated case
management systems, have a significant impact. Legislation can also help
establish strong penalties for fraud, including higher monetary penalties that
could be used to hire more UI investigators. DOL established a nationwide goal
of recovering 55 percent of the total benefit overpayments identified each year,
whether or not they are due to fraud.[14]
In 1998, only ten other states had a lower recovery percentage for fraudulent
overpayments than Texas. The US average that year was 50.9 percent, compared to
Texas’ 40.1 percent recovery rate. If Texas had achieved the US average,
the state would have collected an additional $1.9 million. Also in 1998, Texas
recovered only 47 percent of non-fraudulent UI overpayments, compared to the US
average of 56 percent. If Texas had achieved the US average, the state would
have collected an additional $4 million. Texas’ overall recovery rate of
45 percent was well below the federal benchmark of 55
percent.[15] In 1999, Texas collected $352,498,
only 30 percent of identified fraudulent
overpayments.[16]
States can collect overpayments by contracting with private collection
agencies, referring delinquent accounts to private attorneys or collection
agencies, or debiting a client’s federal or state benefit
payments.[17] TWC has the authority to withhold
UI overpayment amounts from lottery winnings, but has not yet established a
system to do so, because it assumes that a very small number of individuals who
owe money to the UI system will win the lottery.
In August 1999, TWC launched a one-year pilot program with a private
collection agency to recover UI overpayments. Since TWC is precluded from using
a contingency contract—one in which the vendor is paid out of the UI
overpayments collected—TWC set aside $50,000 in administrative funds to
pay the collection agency a 14.9 percent commission on any overpayments they
collected, up to $335,000. Although the contractor had access to a $30 million
pool of uncollected overpayments, it collected only
$225,000.[18]
One collection tool available to state agencies is the Comptroller’s
“warrant hold” program. It prohibits the Comptroller and state
agencies from making payments to businesses and individuals who owe the state
money. Agencies are required to report to the Comptroller individuals who are
indebted to the state or have a tax delinquency after they have taken initial
steps to collect the debt as required by the Office of the Attorney General. TWC
reported that 96 percent of its delinquent obligations for UI benefit
overpayments were classified as uncollectible in 1998. However, as of July 1999,
the Comptroller’s Texas Identification Number System, which captures tax
delinquency and state indebtness information, showed that no delinquencies for
benefit overpayments had been reported to the warrant hold program by TWC.
[19]
Recommendations
A. The Texas Workforce Commission (TWC) should
conduct a study to determine, to the fullest extent possible, the amount of
fraudulent claims in the unemployment insurance (UI) system.
The study should establish the most effective possible fraud detection
methods and should make full use of TWC’s new automated UI systems. It
should be modeled on fraud studies in other government benefit programs, such as
the Medicaid program. It should include thorough research on fraudulent schemes
used in other states and their methods of detection, as well as an analysis of
the industries most affected by fraud.
B. TWC should aggressively pursue all available
UI overpayment collection strategies.
TWC should establish clear UI collection targets for its investigation staff
and expand the use of available collection tools. TWC should make full use of
the Comptroller’s “warrant hold” program by establishing
warrant hold criteria and referring appropriate UI overpayment delinquencies to
the program. This could reduce some UI overpayment delinquencies through the
Comptroller’s authority to offset state tax refunds or other payments. TWC
should also pursue criminal convictions for fraud against the UI system more
aggressively.
C. TWC should contract with a private collection
agency on a contingency fee-basis by adding the fee to the total amount of the
benefit overpayment.
The State of Colorado added a 28 percent fee to overpayments to fund a
contract with a collection agency without having to use additional
resources.[20] Such a move would allow TWC to
contract with a collection agency without using its existing budget.
Fiscal Impact
The study should be conducted using existing resources; automated systems
have already been implemented with existing funds.
Using preliminary data, if Texas improved its collection rate on overpayments
to meet national averages, the state would collect an additional $6 million in
fraudulent overpayments each year beginning in fiscal
2003.[21]
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Fraud
OverpaymentRecovery
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Rate
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Non –Fraud OverpaymentRecovery
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Rate
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Total
Overpayment
Recovery
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US
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$ 260,424,166
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50.90%
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$ 268,301,179
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56.10%
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$ 528,725,345
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Texas
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$ 7,240,516
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40.10%
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$ 21,840,768
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47.40%
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$ 29,081,284
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|
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|
|
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If Texas at National Rate
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$ 9,190,580
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$ 25,849,517
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$ 35,040,097
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|
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|
|
|
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Difference
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$ 1,950,064
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$ 4,008,749
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$ 5,958,813
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Fiscal
Year
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Savings to
Unemployment Insurance
Trust Fund
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2002
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$ 0
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2003
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$5,959,000
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2004
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$5,959,000
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2005
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$5,959,000
|
2006
|
$5,959,000
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[1] US Department of Labor,
“SESA UI Statistics for CY 1999,”
(http://www.workforcesecurity.doleta.gov/unemploy/cy99_stat.asp).
(Internet document.)
[2 ] US Department of Labor,
Office of Inspector General, Unemployment Insurance Integrity: Fraud and
Vulnerabilities in the System, Washington, DC, March 31, 1999, pp.
1-5.
[3] “31 Are Charged With
Taking Jobless Aid Despite Working,” The New York Times, September
10, 1999, p. B-5.
[4 ] “New Hire Reporting
Law,” The State Journal-Register, Springfield, Illinois, November
11, 1998, p. 29.
[5 ] “Are Workers On
Holiday Also Jobless?” The Omaha World-Herald, January 17, 1999, Page
1-A.
[6 ] “Authorities Round
Up 16 in Unemployment Check Scam,” The Advocate, Baton Rouge,
Louisiana, April 9, 1999, pp. 2-B, X.
[7] US Department of Labor,
UI Overpayment Recovery Project, Washington, D.C., March 1998, pp.
B-1 – B-4.
[8] US Department of Labor,
“Detection of UI Fraud in the US,” – Table 3; and
“Percentage of Fraud to Non-fraud Overpayments by State for 1995 –
Table 9,” Washington, D.C., 1996,
(http://www.itsc.state.md.us/ui_integrity/ui_fraud.html).
(Internet document.)
[9 ] Calculation based on US
Department of Labor, UI PERFORMS CY 1998 Annual Report, Washington, D.C., August
1999, p.226,
(http://www.itsc.state.md.us/data_stats/cy98_report.pdf).
(Internet document.)
[10] “Jobless Dialing
for Benefits,” The Dallas Morning News, May 17, 1998, p.
43A.
[11 ] Memorandum from Joe
Adams, director of Planning, Texas Workforce Commission, regarding Private
Vendor Recovery Activities – Employer Delinquent Taxes and Claimant
Benefits Overpayment, Austin, Texas, July 6, 2000.
[12 ] US Department of Labor,
Office of Inspector General, Unemployment Insurance Integrity: Fraud and
Vulnerabilities in the System, Washington, DC, March 31, 1999, pp.
12-16.
[13] Interview with Lynn Q.
Vance, program director, UI Support and Customer Service, and Elaine Bouquet,
supervisor, Benefit Payment Control Unit, Texas Workforce Commission, Austin,
Texas, August 4, 2000.
[14 ] US Department of Labor,
“Benefit Payment Control Technical Assistance Guide, Chapter V.
Overpayment Recovery Activities,”
(http://www.itsc.state.md.us/prog_info/BPC/report_analysis/cover.htm).
(Internet document.)
[15 ] Calculation based on US
Department of Labor, UI PERFORMS CY 1998 Annual Report, Washington, D.C., August
1999, p.226,
(http://www.itsc.state.md.us/data_stats/cy98_report.pdf).
(Internet document.)
[16] Calculation based on
ETA 227 reports, US Department of Labor, ETA 227 Overpayment Detection and
Recovery Activities for Texas, periods ending 3/31/99 through
12/31/99.
[17] Unemployment
Overpayment Recovery Project, “Overpayment Recovery – Best
Practices: Colorado,”
(http://www.itsc.state.md.us/prog_info/BPC/report_analysis/cover.htm).
(Internet document.)
[18 ] Interview with Lynn Q.
Vance, program director of UI Support and Customer Service, and Elaine Bouquet,
supervisor of the Benefit Payment Control Unit, Texas Workforce Commission,
Austin, Texas, August 4, 2000.
[19] Texas Comptroller of
Public Accounts and Texas Office of the Attorney General, State Collection of
Receivables and Delinquent Obligations: Final Report, Austin, Texas,
December 1998, pp. 4, 8, 14, and 28.
[20] Unemployment
Overpayment Recovery Project, “Overpayment Recovery – Best
Practices: Colorado,”
(http://www.itsc.state.md.us/prog_info/BPC/report_analysis/cover.htm).
(Internet document.)
[21 ] US Department of Labor,
“UI Performs Annual Report CY 1998,” p. 226,
(http://www.itsc.state.md.us/data_stats/cy98_report.pdf).
(Internet document.)
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