1. Balancing Anti-Fraud Efforts and Due Process in Indiana
OCTOBER 2016
Balancing Anti-Fraud Efforts and Due Process in Indiana
Kate Shelby
Unemployment Insurance Director
State of Indiana

2. Indiana Program Performance
2014
Improper Payment Rate: 14.02%
Benefit Fraud Rate: 1.26%
Overpayment Detection Rate: 48.45%
Overall First Pay: 67.8%
Separation Determination Quality: 67.39%
Non-Separation Determination Quality: 46.81%

3. Due Process in Action
Benefit determinations often involve three parties
We cannot force employers to respond timely or at all
“When due” means we have a time limit on initial determinations
We cannot wait forever for parties to respond
We must make a decision on the best available information
“When due” means we have a very restricted time limit on continued claims determinations
Decisions must be issued within 7 days
We cannot stop benefits while investigating issues on continued claims
Data and information lag times
Data for important crossmatches is not provided in real time

4. Plan of Attack Fix Adjudication quality.
Hire more adjudicators to meet first pay.
Assess existing fraud prevention, detection, and recovery measures.
Implement additional measures, as needed.

5. Existing Anti-Fraud Measures
SSA verification: real time
Fictitious Employer and Claims Data Analysis
State Directory of New Hires
State Employee Records crossmatch
Claimant wage records crossmatch
State tax return interception
Prosecution program

6. Changes and New Programs
Pay and Chase Programs
Expanded and Automated State and National New Hire Directory Crossmatch
Jobs for Hoosiers Program
Automated wage records crossmatch
Death Records Index Crossmatch
Close to “Real Time” Programs
IP Address Tracking
Data Analysis and Match Program
BMV identity verification
Automated Workflow
Deterrence Programs
TOP
Administrative Wage Garnishment

7. Indiana Program Performance
2014
Improper Payment Rate: 14.02%
Benefit Fraud Rate: 1.26%
Overpayment Detection Rate: 48.45%
Overall First Pay: 67.8%
Today
Improper Payment Rate: 9.71%
Benefit Fraud Rate: 0.37%
Overpayment Detection Rate: 93.55%
Overall First Pay: 91%

8. Issues That Will Remain As Long As States Must Pay Under Current “When Due” Rules:
Pay and Chase
BYE errors
Data Lag
Scarcity of Resources