Wednesday, December 1, 2021

$1.2T infrastructure plan provides attractive target for fraud

Lawmakers passed a US$1.2 trillion bipartisan infrastructure bill on November 5, 2021, with talks still underway on Democrats’ $1.75 trillion plan to expand the social safety net and tackle climate change.

The proposed $3 trillion in total spending is not only a huge investment but a serious target for fraud.

Most government spending reaches targeted goals – such as mass transit, clean energy and broadband Internet – but some money will undoubtedly be lost to fraud. How much is impossible to predict, but I believe a reasonable estimate based on past spending and research would put it around 5% or $150 billion. It is equal to the GDP of Ukraine.

I study the problem of fraud in public spending and what the government can do to fight it. Research shows that there are measures that can effectively fight fraud in government spending, such as an increase in government anti-fraud lawsuits.

The problem is that lawmakers don’t always prioritize preventing fraud.

What is fraud?

In its most basic form, fraud is the use of deception to obtain financial or personal gain. When it involves government spending, fraud occurs when someone uses money for their intended public purpose.

Common examples of government fraud include companies or bureaucrats who falsify providing lucrative government contracts, health care companies misrepresenting patient data to obtain higher payments from Medicare or Medicaid, and Department of Defense officials. Contractors incur the cost of services.

While it is common to hear claims that individual fraud is rampant in programs such as the Supplemental Nutrition Assistance Program, most fraud involves companies paid by the government to provide public services – because there is too much money on the line.

About 15 per cent of government spending goes directly to companies through contracting. Even more flows to Medicare and Medicaid providers, who are often private companies that are reimbursed for the services they provide.

Fraud is part of the problem of driving what economists call information asymmetry. This happens when the construction company or hospital working for the government has more information about billing than the bureaucrats. Fraudsters can take advantage of what they know and the government does not take advantage of them by overcharging.

cost of fraud

It is difficult to measure the exact costs of fraud, as people who commit fraud try to hide it.

One measure of how much fraud causes the US government to suffer is its unfair payment rate – a measure of the amount the government should not have made, for example, duplicate payments or payments to ineligible people. Improper payments totaled $175 billion in 2019, or about 4% of all government spending.

Different programs have different unfair pay rates. Medicare, for example, makes unfair payments in the 5%-6% range, costing the government billions of dollars per year.

However, improper payment is not the most accurate measure of fraud. They include money paid improperly by accident rather than malice, but they fail to measure fraud that was not caught – which may be substantial but is unknown. There is a constant cat and mouse game between anti-fraud and fraudsters taking advantage of new opportunities in the ever-changing regulatory landscape.

For example, the Payment Protection Program — which spent $792 billion to help small businesses bear the economic effects of the COVID-19 pandemic — could lose $76 billion to fraud, according to a 2021 study. Is.

About 15% of the PPP loans given are suspected of fraud. This is based on certain red flags, such as filings that include unregistered or recently incorporated businesses, similar residential addresses or higher employee salaries.

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Other recent stimulus programs have similarly attracted attention for fraud, including the pandemic unemployment assistance program, in which hundreds of thousands of people have used their identities to make fraudulent claims. Ohio alone is estimated to have lost $330 million in such fraud.

Like other forms of fraud, the problem was largely not caused by individual abuse, but by criminal organizations exploiting weak government oversight.

Infrastructure fraud is a particularly attractive target

Information asymmetry is one reason why infrastructure programs are particularly prone to fraud.

For example, it is difficult to verify the quality of construction projects. This gives contractors and builders the opportunity to skimp on materials or increase costs to make more profit.

Boston’s Big Dig, a $15 billion infrastructure megaproject from the early 1990s, resulted in the arrest of some contractors for fraudulently providing substandard materials. A prime contractor on the project was prosecuted and fined $50 million for delivering adulterated concrete.

Also, infrastructure projects are usually awarded to a single company through a bidding process, which can be susceptible to rigging. For example, in June 2021, an Ohio-based engineering company was ordered to pay an $8.5 million fine for rigging several drainage projects in North Carolina.

The US is sophisticated in its rules for bidding, contracting, and auditing, but such matters still come up with some regularity.

fight fraud

The federal government is not powerless to prevent and detect fraud.

Its tools include increased regulatory requirements for criminal enforcement, whistleblowing and civil prosecution, auditing, spending, and machine-learning tools for data mining and forensic analysis.

Research has found that many anti-fraud efforts can successfully root out fraud. Indeed, the Justice Department has found that every $1 spent on health care fraud in 2020 returned $4.30 – an exceptionally good return on investment.

Whistling has proven to be particularly valuable. Under the False Claims Act, individuals who have information about fraud involving government programs can hire their own attorneys and sue on behalf of the government in federal civil court. These whistleblowers receive a portion of any money they charge for the government.

My research has found that it can be highly effective in preventing fraud. Under this act, the government recently recovered over $1 billion a year, and my research shows that it has saved tens of billions more by preventing fraud from happening in the first place.

But the $1.2 trillion package contains little language intended to fight fraud. Attempts to include stronger provisions for whistleblowing in the infrastructure bill failed.

Other languages ​​in the bill direct the government to prevent waste and fraud, but do not specify penalties or how it would be done. In fact, the word fraud appears only seven times in the 2,000-page bill—and refers to a congressional act preventing the Office of the Inspector General of Health and Human Services from strengthening anti-kickback rules.

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It is clear that the current rush to spend federal money has not been given enough attention to ensure that it all goes to the proper places. Second, the big spending package is still mainly just a blueprint, with not much legislative language behind it.

Lawmakers would be wise, considering how much they plan to spend in the coming years, to include more anti-fraud language in large spending bills. This will help ensure that more of these trillions of dollars go to people and places they say support is needed – not to fraudsters.

This article is republished from – The Conversation – Read the – original article.

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