OIG Referrals: Making a Referral to the OIG

When to Make a Referral

Before making a fraud complaint to the Office of Inspector General (OIG), ask yourself the following questions:

  1. Is there “reasonable suspicion” that a crime has occurred? If you believe there is, state your basis for reasonable suspicion on the 19MP001E (OIG-1) and include what law or policy you believe has been violated. You are the policy expert.
  2. What evidence do you have that the crime or policy violation occurred? This may include wage or resource verification, lease information, court records, written statements, etc. Please provide as much information as you know about the situation and attach copies of the documentation you have to the 19MP001E (OIG-1).
  3. What will the probable overpayment amount be? If it is less than $500, you should consider submitting it to the Benefit Integrity and Recovery Section (BIRS) of state office rather than to OIG. If it is more than $500, you should send it to OIG instead of BIRS. Please do not send it to both. OIG and BIRS work closely together on many cases, and we want to avoid working the same case twice.
  4. Is there any report of trafficking of SNAP benefits? A referral should be submitted to OIG no matter the dollar amount.

Making a Quality Referral to OIG

Take a look at these examples. Each shows how a poor quality referral can be made into a good quality referral just by including additional information. In some cases, you may not have this additional information, but when you do know more, please include what you know.

Example 1

Poor quality: Sally Smith’s children don’t live in the home and she is claiming them on her SNAP case.

Good quality: Sally Smith’s children, Bobby and Jimmy, don’t live in the home and she is claiming them on her SNAP case. Both children have lived with Susan Smith, their grandma, since 10/2012. This is according to Worker White’s conversation with Susan Smith on 01/15/2015. Susan Smith lives at 123 Elm, Fairbanks, AK. Grandma’s phone number is (555) 555-5555. (additional info attached)

Example 2

Poor quality: Billy Bob is receiving income he failed to report.

Good quality: On 01/15/15 Billy Bob applied for SNAP claiming $0 income. At the review on 07/06/15, worker Smith discovered client’s income via OWL. Worker obtained wage verification from EZ Mart. Bob received EZ mart income in excess of $1200 per month during the period 11/2014 through 06/2015. He failed to report this income to DHS while receiving SNAP. (additional info attached)

Comments or Suggestions?

We want Quest to be your source for important information that you need to succeed at in your work but we need your help:

Was this article helpful? Was it missing something you needed to get the job done?

Tell us what you think, what you know about this article. What are we doing well, and what we could do better.

All fields are required.

  • Hidden
  • Hidden