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DHS seeks expanded authority, analytics and staff to detect and prevent fraud, waste and abuse
Summary
Temporary Commissioner Shereen Gandhi and DHS staff told the committee the Office of Inspector General has completed thousands of investigations but needs more data-sharing authority, staff, and analytic tools (including AI) to detect improper payments and to act more quickly across agencies.
Temporary DHS Commissioner Shereen Gandhi told the House Human Service Finance and Policy Committee that the department's Office of Inspector General has completed more than 4,000 investigations over the past five and a half years and that the governor's budget proposes new authority, staff and data tools to reduce improper payments and speed referrals to law enforcement.
Gandhi and DHS presenters said the package would add program integrity investigators and provider eligibility staff, fund prepayment review for high-risk providers, expand authority to share data across agencies, allow immediate license suspension for a controlling individual who is criminally charged, and permit payment withholds where there is a criminal conviction or a background-study disqualification.
The nut graf: DHS argued staffing and analytics investments would help identify and stop fraud more efficiently; DHS cited a $1.89 return on investment for each dollar spent on program-integrity functions and asked for statutory clarifications that would permit quicker cross-agency action when bad actors are identified.
Presenters described expanded use of analytics, automated case management, and AI-supported risk scoring to sift Medicaid claims and flag high-risk cases for review. Gandhi referenced the "Feeding Our Future" fraud case as a lesson about the need for better interagency data sharing; committee members pressed DHS about how much money the department has recovered and whether outside audits or external partners had been used.
Ending: DHS said it would provide additional detail about recoveries and the scope of existing interagency investigative partnerships and defended proposals as both a way to protect taxpayer funds and to reduce harm to legitimate providers and program recipients.
