DHHS' Fraud Investigation & Recovery Unit Uncovers More Than $1.7 Million in Welfare Theft

AUGUSTA - Lying about income, falsifying documents, using a deceased parent's benefits, stealing from the elderly and selling a child's prescription medication are just a few examples of the criminal cases of welfare fraud investigated by Department of Health and Human Services (DHHS) in 2016. Last year, the Department's Fraud Investigation and Recovery Unit (FIRU) brought a record $1,701,983 in welfare fraud cases to the Attorney General's office for prosecution. Additionally, FIRU worked with local District Attorney's offices along with local and county law enforcement on cases of fraud.

A total of 174 criminal cases were referred from DHHS for prosecution in 2016.

"We are pleased that our efforts to reign in welfare fraud, waste and abuse continue to pay off," said DHHS Commissioner Mary Mayhew. "We've not only made significant progress towards turning back the wave of welfare dependency that overtook Maine for so many years, but we're doing our part to help stamp out the fraudulent use of benefits. We need to uphold the integrity of our welfare system and ensure scarce taxpayer resources are going to the neediest and most vulnerable."

welfare fraud chart

Examples of Welfare Fraud:

image

Gloria Roderick of Lewiston pled guilty to charges of theft by deception and trafficking of benefits. For nearly a year, Roderick sold her food stamps totaling $2,440. During the investigation Roderick admitted she would use money from the sale of her EBT cards for items she wanted to purchase and utilized local, charitable food pantries as her source for food.

image

Lisa Schofield was convicted of stealing $11,929.40 in food stamp and MaineCare benefits by claiming she was a Maine resident. The investigation uncovered Schofield was living in New Hampshire with her wealthy fiancé, now husband, and wintering in Florida every year. Schofield was sentenced to 11 months in jail, one year of probation and will need to complete 175 hours of community service.

image

Tanya Boutelle was indicted by an Androscoggin Grand Jury on various counts of theft by deception totaling more than $150,000. This case began as a welfare fraud case when investigators discovered the 54-year old woman was not reporting her income to the State and was receiving in excess of $3,700 in welfare benefits she was not entitled to. It led to uncovering a significant elder financial abuse case. At least 12 victims were involved and others came forward after it appeared in the media.

image

Robert Woods, Jr. was indicted in Cumberland County on one count of Class B theft by deception. Woods allegedly failed to report his income from 2010 to 2013. As a result, he received $21,000 in Food Supplement and MaineCare benefits he was not entitled to.

image

Jason Seger of Greene was indicted by an Androscoggin Grand Jury on two counts of theft and one count of forgery. Investigators allege Seger was using his deceased father's Supplemental Nutritional Assistance Program (SNAP) benefits and cashing his worker's compensation checks.

image

Kelly Mann pled guilty in Knox County to one count of Theft by Deception and two counts of Unsworn Falsification. Mann stole $54,509.91 in state benefits by failing to report that her husband was living in the household, consequently, his income was not reported to the Department. In a plea deal, she was sentenced to 4 years, with all but 6 months suspended, along with 3 years of probation. She paid $500 in restitution immediately upon her plea and was ordered to pay the balance as part of her sentence.

Theresa Sudsbury (not pictured) of Guilford pled guilty to one count of Theft by Deception and one count of Unsworn Falsification. Sudsbury stole $24,787 in Food Stamps by inaccurately reporting her income, not informing the state she was married and her husband was living in the household. The investigation began when a DHHS Quality Assurance Worker noticed discrepancies and alerted the Fraud Unit. The court ordered full restitution to be paid.

The FIRU's Overpayment Specialists are also integral to the Department's work. These individuals work alongside the Fraud Investigators calculating the dollar amount of theft, or overpayment to clients, in these cases. Additionally, Overpayment Specialists uncover ineligible payments to clients and through hearings or consent agreements are then able to recoup those funds for the State. In 2016, the Overpayment Specialists uncovered 521 Intentional Program Violations (IPV) where an individual incorrectly reported information to the state. This resulted in 497 sanctions to clients. Those clients were removed from the benefit program for a period of 12 to 24 months while others received lifetime sanctions, barring them from ever receiving benefits in any state. These sanctions represent an estimated $3,183,963 in cost avoidance and are calculated by multiplying the length of the sanction by the benefit amount the household would have received had they stayed on benefits.

In 2016, the Fraud Investigation and Recovery Unit received 2,798 complaints alleging welfare abuse.

Community (Public) 1,977
Law Enforcement 146
FIRU Generated 201
Office for Family Independence 240
PARIS Match Nationwide Benefits Match 77
Governor's Office/Constituent Calls/Other 157

The Department of Health and Human Services is committed to improving the program's integrity and operational effectiveness. If you want to report potential fraud, you can do so online or by calling the state's Fraud Hotline at 1-888-348-1129.

Online Fraud Reporting Form: https://www.maine.gov/dhhs/fraud/