Financial Crime World

Title: Georgia’s War on WIC Fraud: The Advanced Quantitative Analysis behind Georgia’s Fraud Detection and Prevention System

Date: December 13, 2016

Speaker

  • Chavis Paulk, MPA

Event

  • Nutrition Services Directors Meeting

Location

  • Georgia WIC Program (GAWIC)

Georgia’s Fight Against WIC Fraud

Advance Fraud Detection and Prevention System (FDPS)

With the fifth largest WIC Program in the US, serving approximately 250,299 participants in FY2016, and a cumulative food cost of $91.5 million, even a small degree of fraud can result in significant financial losses. To combat fraud, GAWIC has established an advanced Fraud Detection and Prevention System (FDPS).

Objectives of FDPS

  • Combat fraud through quantitative analysis
  • Collaborate with border states

GAWIC by the Numbers

  • Approximately 250,299 participants
  • Cumulative food cost: $91.5 million
  • Participant investigations for FFY 2015: 0.090% of Georgia WIC participants
  • Demographics:
    • 62% White
    • 38% Black or African American
    • 7% Hispanic or Latino
    • 3% Other
  • Female participants: 62%
  • Male participants: 38%

Collaborative Initiatives

Several local health districts, the Georgia Department of Public Health, Emory University, and border states (Tennessee, Alabama, Florida, South Carolina, and North Carolina) have joined forces in the fight against fraud.

Fraud Detection Methods

Focus Groups

The current and proposed fraud detection methods will be evaluated through a series of focus groups. In these focus groups, methods, both existing and new, will be assessed based on their effectiveness. Methods of detecting participant fraud, such as reviewing existing tools and systems, will also be examined.

Analytical Models and Data Collection Techniques

The FDPS relies on analytical models and data collection techniques to identify potential fraud cases. These techniques include:

  • Rules-based models
  • Anomaly models
  • Predictive models
  • Spatial analysis
  • Network link analysis

Reducing Fraud and Maintaining Program Integrity

By using these advanced tools, GAWIC aims to reduce fraud and maintain the integrity of the program. For more detailed information on fraud allegations, investigations, and referrals by district, local agency participation, and experience, please refer to the evaluation framework provided.