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How the PARIS Interstate Match Has Evolved in Wisconsin Office of the Inspector General Fraud Investigation, Recovery and Enforcement Section PARIS Conference – March 15, 2016 Presented by Michael McKenzie and Jolyne Franklin PARIS

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Page 1: How the PARIS Interstate Match Has Evolved in …...No trafficking investigations Cited annually by Food and Nutrition Service (FNS) for low claims establishment PARIS Moving Forward!

How the PARIS Interstate Match Has Evolved in Wisconsin

Office of the Inspector General Fraud Investigation, Recovery and Enforcement Section

PARIS Conference – March 15, 2016 Presented by Michael McKenzie and Jolyne Franklin PARIS

Page 2: How the PARIS Interstate Match Has Evolved in …...No trafficking investigations Cited annually by Food and Nutrition Service (FNS) for low claims establishment PARIS Moving Forward!

P A R I S

State supervised, locally administered

72 counties, 9 tribes

Just over 5.7 million people live here

Milwaukee metro area about 1.6 million

About 795,000 people receive FoodShare (FS) benefits

About 1.2 million people receive some kind of Medicaid (MA)

A little bit about

Page 3: How the PARIS Interstate Match Has Evolved in …...No trafficking investigations Cited annually by Food and Nutrition Service (FNS) for low claims establishment PARIS Moving Forward!

P A R I S

Miller Park, home of the Milwaukee Brewers, is the only baseball stadium that sells more brats than hot dogs.

Wisconsin Statute 97.18, aka the “oleomargarine rule,” makes it against the law to substitute margarine for butter in a restaurant unless the customer requests it…

A little more about

Page 4: How the PARIS Interstate Match Has Evolved in …...No trafficking investigations Cited annually by Food and Nutrition Service (FNS) for low claims establishment PARIS Moving Forward!

P A R I S

Today’s Presentation The Way We Were

Moving Forward

Building the PARIS Team

PARIS Pilot Project

Where We Are Now

PARIS Success Stories

Where We Are Headed

Page 5: How the PARIS Interstate Match Has Evolved in …...No trafficking investigations Cited annually by Food and Nutrition Service (FNS) for low claims establishment PARIS Moving Forward!

P A R I S

The Way We Were One person to manage the fraud program

Each county and tribe administering its own fraud program

Two PARIS agents, contracted through the University of Oshkosh, processing PARIS matches

Separate funding allocated for front end and fraud investigations

Little accountability, guidance, or monitoring

Fraud prevention and detection not highly prioritized

Page 6: How the PARIS Interstate Match Has Evolved in …...No trafficking investigations Cited annually by Food and Nutrition Service (FNS) for low claims establishment PARIS Moving Forward!

P A R I S

The Way We Were Funding varied annually

No $ allocated to agencies in 2010

Very few Intentional Program Violation (IPV) sanctions

No trafficking investigations

Cited annually by Food and Nutrition Service (FNS) for low claims establishment

Page 8: How the PARIS Interstate Match Has Evolved in …...No trafficking investigations Cited annually by Food and Nutrition Service (FNS) for low claims establishment PARIS Moving Forward!

P A R I S

Moving Forward! January 2011 – Governor Scott Walker established the Governor’s Commission on Waste, Fraud and Abuse

October 2011 – Wisconsin Department of Health Services created the Office of the Inspector General (OIG)

Wisconsin’s 2011-13 biennial budget authorized nineteen new OIG positions, including four additional PARIS agents for a total of six

Page 9: How the PARIS Interstate Match Has Evolved in …...No trafficking investigations Cited annually by Food and Nutrition Service (FNS) for low claims establishment PARIS Moving Forward!

P A R I S

Fraud Consortia

Page 10: How the PARIS Interstate Match Has Evolved in …...No trafficking investigations Cited annually by Food and Nutrition Service (FNS) for low claims establishment PARIS Moving Forward!

Mike McKenzie Section Chief

Vacant WIC Monitoring

Coordinator

Jean Diedrich WIC Authorization

Manager

Chris Grover WIC Vendor

Manager

Alan Sheil WIC Compliance

Manager

Svea Erlandson WIC License/Permit Program Associate

Vicki Harkins WIC Vendor

Auditor

Carrie Coenen Supervisor

WIC Vendor and Integrity Unit

Jolyne Franklin Supervisor

Trafficking Enforcement and PARIS Unit

Wendy Metcalf Supervisor

Investigation and Technical Support Unit

Donald Shogren HSPC

Kim Reniero Data and

Research Analyst

Nadine Stankey Card Trafficking Agent

Diane Peterson PARIS Agent

Megan Ryan PARIS Agent

Kris DeBlare PARIS Agent

Jolyne Pedracine PARIS Agent

Leslie Vosters PARIS Agent

Aimee Rentmeester PARIS Agent

Nicole Housley Card Trafficking Agent

Kevin Rinka Card Trafficking Agent

Tanya Allen Fraud Investigator

Nick Kwaw Fraud Investigator

Elizabeth Branney-Gant

Fraud Investigator

Melissa Elson Fraud Investigator

Keegan Trentsch Fraud Investigator

Sherrie Johnson Fraud Investigator

Candice Canales Fraud Investigator

Robert Klingforth Fraud Investigator

Mary Lou Castro HSPC-Senior

Overpayment Specialist

P A R I S

Fraud Investigation, Recovery and Enforcement Section

Page 11: How the PARIS Interstate Match Has Evolved in …...No trafficking investigations Cited annually by Food and Nutrition Service (FNS) for low claims establishment PARIS Moving Forward!

P A R I S

Building the PARIS Team Assigned each agent a portfolio of states

Agents reviewed and investigated their assigned states’ cases from the quarterly PARIS Report

Agents established and processed their own overpayments

Agents conducted their own fair hearings

Page 12: How the PARIS Interstate Match Has Evolved in …...No trafficking investigations Cited annually by Food and Nutrition Service (FNS) for low claims establishment PARIS Moving Forward!

P A R I S

Building a Collaborative Effort

Promoted the PARIS team statewide

PARIS presentations at state conferences

Reviewed benefit recovery processes statewide

Encouraged feedback from agencies

Attended monthly fraud prevention integrity meetings with consortia

Page 13: How the PARIS Interstate Match Has Evolved in …...No trafficking investigations Cited annually by Food and Nutrition Service (FNS) for low claims establishment PARIS Moving Forward!

P A R I S

PARIS Pilot Project

Six month project – April 1, 2014 through September 30, 2014

Three PARIS agents and their 26 assigned states

Expected outcome

Results

Page 14: How the PARIS Interstate Match Has Evolved in …...No trafficking investigations Cited annually by Food and Nutrition Service (FNS) for low claims establishment PARIS Moving Forward!

P A R I S

Where We Are Now

Four PARIS agents working referrals through overpayment claims

Two PARIS agents processing IPV/ADH/waivers (backlog and current)

Results

Page 15: How the PARIS Interstate Match Has Evolved in …...No trafficking investigations Cited annually by Food and Nutrition Service (FNS) for low claims establishment PARIS Moving Forward!

P A R I S

Where We Are Headed

Review of analytics suggest the following:

Six PARIS agents to process their own assigned states’ referrals from investigation through IPV

Emphasis on cooperating states

Increased focus on geographical trends

Page 16: How the PARIS Interstate Match Has Evolved in …...No trafficking investigations Cited annually by Food and Nutrition Service (FNS) for low claims establishment PARIS Moving Forward!

P A R I S

Thank You! Presenter Contact Information:

[email protected] 608.266.0930

[email protected] 608.267.2849