Florida Welfare Fraud Overpayment Backlog Reduction and Process Improvement

In 2013, the State of Florida Contracted with The Stephen Group to help Reduce its Backlog of Beneficiary Welfare, Medicaid and TANF Fraud/Overpayment. From May to July 2013, The Stephen Group assigned a team to work alongside the SunCoast Region Benefit Recovery Unit and establish overpayment claims that were in the referral backlog, but to also assess the efficiency of worker productivity, create a prioritization process for working the most value added overpayment claims to the state, including those involving intentional fraud, and designing an automated process that fully automates the data collection for earnings data, thus, allowing earnings and unemployment compensation referrals to be processed much quicker.

Working along-side the state staff, together the team was able to establish over 1000 claims, doubling the two month state original goal of 500, identify overpayments owed to the State of Florida in the amount of $847,000, identify a new and improved way of handling claims and establishing the framework for a new and improved quality assurance program. The Claims prioritization tool designed and delivered by TSG will also result in a significant enhancement of future overpayment collections.

TSG delivered its complete project assessment to the State that will lead to further process improvements as follows:

  • A roll out of a more automated and efficient process;
  • Future revisions to staffing around a new and improved process and more automated investigation;
  • better handoffs and interactions with Fraud Investigative and Eligibility Determination Unit