Los Angeles County using SAS® to spot child care benefits fraud, conspiracies
System has generated more than 200 fraud referrals, while helping prioritize and enhance the review of case
Los Angeles County's Department of Public Social Services (DPSS) is using SAS® to help fight organized fraud rings and individual perpetrators that prey on benefits meant for the community's most vulnerable. Using fraud-fighting analytics and data mining tools from SAS, L.A. County uncovered more than 200 probable fraud cases and busted ongoing conspiracies to defraud the California Work Opportunity and Responsibility to Kids (CalWORKs ) Child Care benefits program.
The county provides financial and employment assistance to qualified families with minor children. The SAS Fraud Framework for Government helps ensure that only those truly in need of those benefits receive them.
"Fraudulent activity reduces funds available to those truly in need and hurts public confidence in a vital program," said Michael J. Sylvester II, DPSS Assistant Director and Department Chief Information Officer. "Reducing fraud and catching those responsible builds public confidence; the Data Mining Solution (DMS) that L.A. County and SAS developed together is critical to that effort."
Finding fraudsters, revealing conspiracies, supporting investigations
Alerts generated by the DMS have delivered more than 200 fraud referrals that could have otherwise gone unnoticed for an extended length of time by relying strictly on traditional fraud detection processes. Additionally, using SAS Social Network Analysis, DPSS Welfare Fraud Prevention and Investigations (WFP&I) uncovered two conspiracy rings comprising 16 cases much earlier, significantly reducing the duration of fraudulent activities. Social network analysis provides investigators instant access to a network of child care recipients and providers, saving hours of casework preparation.
"With a single mouse click, SAS provided leads to additional evidence that could have taken weeks or months to uncover, including linking my suspect with two in other cases," said one investigator.
Another investigator, who was wrapping up a 10-person investigation, entered the main suspect's name and discovered seven potential co-conspirators.
Predictive models detect anomalies
SAS generates high risk scores based on predictive models and peer group analysis that detect behavioral anomalies in child care service usage, which decreases false positive cases assigned to investigators. The scores help prioritize cases with a high suspicion level and identify high value targets. Social network analysis detects individuals likely to commit fraud, helps identify collusive fraud rings and identifies companion cases to ongoing investigations.
In addition to SAS Fraud Framework for Government and SAS Social Network Analysis, L.A. County applies predictive analytics and data mining, rules management and forecasting. SAS Business Intelligence generates a portal for monitoring, reporting and sharing information on fraudulent cases.
SAS hosts the county's data at the SAS Analytics Lab for State and Local Government, which partners with state and local leaders to improve government services with advanced analytics technology. There, nearly 300 mostly doctoral-level SAS experts devise technological solutions to government issues such as fraud, tax collection, public safety, pension risk and education.
Before the system went live, SAS and L.A. County conducted a data mining pilot that achieved 85 percent accuracy in detecting collusive fraud rings. Estimates of cost avoidance from new fraud referrals, earlier detection and increased efficiency totaled $6.8 million.
"The successful pilot resulted from a strong public-private partnership between SAS and L.A. County," said Paula Henderson, Vice President of the SAS State and Local Government Practice. "SAS fraud experts and the analytics lab work closely with the county to ensure the live system remains effective in identifying fraudsters and protecting taxpayer money."
SAS is used in all 50 state governments to transform their operations to deliver the right services, at the right time, with the appropriate resources. SAS offers a wide array of data integration, business intelligence and analytics solutions, and collaborates with government to create innovative offerings tailored to specific departmental and agency goals.
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