Reducing Fraud and Abuse in Entitlement Programs: An Evaluative Perspective

Little attention has been directed to the design weaknesses of entitlement programs which present opportunities for fraud and abuse. There has been a failure to envision and formally recognize the possibility of fraud and abuse in benefit programs, a consequent failure to address these problems by designing safeguards against them, a failure to build in provisions and funds for the energetic pursuit of fraud and abuse, and a failure to plan evaluation efforts to measure and describe the fraud and abuse problems and test the effectiveness of fraud and abuse countermeasures. Computer-based management information systems can be helpful in detecting and identifying fraud and abuse, but social workers do not necessarily possess data processing skills. The actual magnitude of benefits lost to fraud and abuse is not known because of inadequate data, which are inconsistently defined and formatted across jurisdictions and, consequently, impossible to aggregate. Little or no research has been done on the effectiveness of prosecutorial and other deterrent strategies. Reducing fraud and abuse in Government programs requires program planning and design which builds in enforcement safeguards, coordinated program operations, and program evaluation which allows the measurements of progress and the determination of the most effective strategies and techniques against fraud and abuse. The ability to ensure that Federal resources actually reach the truly needy and that the increasingly scarce amounts available will not be improperly depleted is dependent on this work.