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Modernizing Data Could Multiply Agency’s Financial Recoveries

The HHS Office of the Inspector General outlined rates of return for upgrading IT, impacting investigations and audits.

A finger print surrounded by lines of code, all in blue.
In testimony that included rates of return for various investments, the Office of Inspector General (OIG) for Health and Human Services (HHS) outlined exceptional items for the upcoming budget.

The office ensures that monies are spent and used as intended and is charged with prevention, detection, audit, inspection and investigation of fraud, waste and abuse in all HHS program delivery.

Inspector General Sylvia Hernandez Kauffman told a Texas House of Representatives subcommittee that her office recovered half a billion dollars in 2022. Financial recoveries are up since 2019 although there are now 16 percent fewer employees. The exceptional request for staff resources is $1.4 million.

Kauffman pointed out during a February legislative Appropriations subcommittee meeting that for every dollar invested, the OIG team can return $6.21. However, she said, it requires IT upgrades to increase overall efficiency.

“We have several systems that are quite antiquated and can’t be integrated effectively into our workflows,” Kauffman said. “We also have units that are still mostly manual in the way that they process and manage cases. These inefficiencies take up our staff’s time and limit the amount of work we can do, which results in fewer recoveries.”

The OIG exceptional items requests are made as part of the Texas Health and Human Services Commission requests.

A request titled “Increase Beneficiary Fraud Detection” would replace the Automated System for the Office of Inspector General (ASOIG).

The case management system was deployed in 2007. It requires time-consuming manual entry, allows for human error and is incompatible with multiple system integrations. A replacement estimated at $3.8 million would enable 5 percent more completed investigations and $5.2 million in annual recoveries.

The request titled “Automate Beneficiary Evidence Collection” would procure automation tools to reduce repetitive tasks.

According to the testimony, staff pull this information from 15 data sources, sometimes requiring six to eight hours per investigation. Kauffman said that for each two-hour reduction, investigation capacity goes up 16 percent and would yield $14 million in recoveries for the biennium.

The request titled “Modernize Case Management System for Special Investigations” would help manage caseloads, manage open records requests and create reports. The system must meet high standards of documentation for state and federal compliance. The cost is $2.4 million.

The request titled “Improve Public Reporting of Fraud, Waste and Abuse” would allow for the replacement of the public-facing web portal where the general public submits tips. This system is 16 years old, cost prohibitive to upgrade yet less expensive to replace, and would increase data collection.

The office has also requested 10 more data analysts and 4.2 full-time equivalent staff for the complex-contracts audit team.
Rae D. DeShong is a Dallas-based staff writer and has written for The Dallas Morning News and worked as a community college administrator.