Work group proposes fraud‑response toolbox: prosecutions, repayment authority and calibrated penalties

A program integrity work group presented a set of recommended authorities and response options for investigating and responding to suspected beneficiary or provider fraud under WA Cares.

Mark Stenzager, who led the work group, said members considered scenarios of beneficiary/provider collusion and emphasized sensitivity to terminating benefits for people who have contributed to the program. "DSHS provide DSHS with response options as tools to address this, such as... criminal prosecution coordinated by the OFA and law enforcement when there is sufficient evidence of criminal fraud," Stenzager said.

The recommendations included (1) criminal prosecution coordinated by the Office of Fraud & Accountability (OFA) and law enforcement for sufficient evidence, (2) OFA authority to collect overpayments, (3) proportional monetary penalties and interest with escalations for convictions, (4) termination of benefits only in escalating cases of repeat offenses and (5) redetermining eligibility where fraud produced false eligibility. Commissioners and attendees suggested cross‑checking existing elder exploitation statutes and consulting AAG input before adopting statutory changes.

The commission was asked to consider the work group's recommendations and vote on them at the October meeting; staff said they would investigate whether existing statutes already provide needed authority and coordinate with OFA and the Attorney General's Office as appropriate.