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Preventing Fraud

Is your government agency using these fraud-prevention tactics?

· 5 minute read

· 5 minute read

The added stress levels that state agencies managing social services benefits such as unemployment insurance (UI), Medicaid, and SNAP have experienced in recent years haven’t stopped with the end of the pandemic-related public health emergency (PHE). In fact, they’re becoming even more challenging. For those agencies managing SNAP benefits, newly established work requirements will add to the complexities of overseeing the program.

If you’re a manager or investigator of benefits applications and claims for a state agency who needs to prevent fraud before it happens, you know that more and more fraudsters – most using false identities – are concocting schemes to steal government benefits. Meanwhile, you and your staff are struggling to keep up with the rising backlog of claims requiring identity verification, review, and investigation.

With fraud schemes becoming increasingly sophisticated, the White House this past spring recently announced a multi-billion-dollar plan to reduce improper payments. Among other things, the proposal requires states to ramp up their fraud detection and prevention efforts (there would be funding to help them do so).

Agencies like yours that are overseeing benefits programs need a variety of identity verification solutions both to prevent bad actors from accessing a program at the front end and to perform due diligence on current program participants. At the same time, you don’t want to delay application and payment processing for people who truly need benefits.

Older manual methods of identification verification aren’t effective in a world where complex digital methods of fraud have become all too commonplace. How can you and your team keep up and fight back? Here are some innovative strategies that public agencies like yours can use for fraud detection and prevention:

Accessing the most current data and digital risk analysis tools for more efficient fraud detection. It’s essential to establish front-end analysis processes to pinpoint any risk or inconsistencies in the applicant’s identity before any benefits are paid. But outdated technology or a lack of a rigorous process make detecting and preventing sophisticated fraud difficult, if not impossible. Digitally driven data analysis can access real-time data from a variety of sources so that an agency can quickly determine whether an applicant is who he or she claims to be. This allows the agency to compare information an applicant provides with continuously updated records. It also allows investigators to establish identity verification at every level – both at the front end and throughout ongoing reviews of current program participants.

Prioritizing the review of claimants who appear to be greater fraud risks and necessitates further investigation over lower-risk applicants. This requires a process that provides short-term backlog relief as well as long-term identity checks. There’s plenty to investigate. Synthetic identity fraud has become more and more prevalent. So have bot attacks, which require agencies to ascertain whether an applicant is in fact a real person. This strategy also provides long-term identity checks at the front end to immediately detect and prevent fraudulent activity.

Implementing a fraud detection system that doesn’t require extra steps for either agency staffers or program participants. This system should include fully automated identity verification, including verification of identity documents. By gathering claimant information via an API, for instance, an agency can quickly review for fraud without requiring any extra step for applicants. This detection platform should include a dashboard that staffers can use for risk detection and to focus their investigative efforts.

Doing Good Work, Stopping Bad Actors

At this point, you may be thinking: This all sounds wonderful. But how can my agency actually put all these worthy strategies in place? Particularly if the budget is tight (as most agency budgets are). What’s more, your agency probably doesn’t have the resources or expertise to sift through large volumes of data to uncover and prevent fraud — and then hand over the perpetrators to law enforcement for prosecution.

One way to establish all the tactics discussed here is an online platform of fraud detection tools that efficiently integrates your agency’s program data, identity verification, and public and proprietary records. This would give you and your colleagues the confidence that you’re confirming the identities of your program applicants and protecting resources from potential fraud.

You can learn more about risk detection and fraud prevention strategies using digital tools by visiting Thomson Reuters Identity Verification Solutions.

 

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