Fraud

The Department of Social Services (DSS) must have an active fraud control plan in order to ensure that public benefits meet the needs of those individuals who are eligible to receive them.

The mission of the Program Integrity (PI) Unit is to assist the New Hanover County DSS in maintaining integrity and public accountability in the administration of its programs and to provide investigation and advisory services to ensure appropriate and efficient use of available public resources.

The PI Unit is a program support unit that devotes maximum efforts toward the prevention, detection, and recovery of over payments in the public assistance programs.

The role of the PI Investigator is to:

  • Discover, pursue, and prevent fraud
  • Seek reimbursement for over issuance/over payments
  • Provide a deterrent to future fraud
  • Maintain program integrity

The PI Unit investigates the over issuance of funds in several social service programs (i.e. Day Care, Food and Nutrition Services, Work First, Family and Children and Adult Medicaid). The cause of such over issuance can be due to human error on the part of either the client or the case worker or a deliberate attempt to intentionally violate program policy and procedure.

The crime of benefits fraud is committed when people receive or attempt to receive welfare benefits by providing DSS false and inaccurate information, or by withholding information needed to correctly determine eligibility for benefits.

The unit often receives complaints from concerned citizens that specific DSS clients are abusing the system that provides them with benefits. These complaints can come from friends of clients, their families, vendors and other sources. The staff investigate every complaint. They actively pursue any leads indicating fraudulent practices and uses them as a source to begin an investigation.

Review decisions can result in clients making refund payments to the program for over issuance of state or federal funds.

The Unit is devoted to ensuring that payments are accurate and that fraud, waste, or program abuse are identified and prevented. Any funds recovered help the federal, state, or county reduce costs. Fraud and abuse takes money from needy children, the elderly, blind and disabled. Therefore, identifying, investigating, preventing and recovering money billed improperly is an important part of the unit’s work.

While many PI reviews are targeted at specific complaints or suspicions, often the reviews are routine. The review process is not intended to impugn the integrity of anyone but merely to verify the accuracy of the need, provision, and payment for the services provided.

Cases are referred to this unit to investigate possible benefits fraud, and when possible, recoup benefits issued erroneously. In addition to collecting monies after an over-payment has occurred, “front end” investigations are also conducted on high risk cases in an effort to prevent over-payments.

For more information on refer to the brochure: A Serious Crime – Public Assistance Fraud. This can be found at the following link:

To report suspected fraud in New Hanover County please telephone DSS at 910-798-3400 from 8 a.m. to 5 p.m. Monday through Friday and ask for the PI Unit. You will be able to speak to an investigator trained in collecting the necessary information. Outside of regular business hours you may call 910-798-3769 and leave a message. All information provided is confidential, and you remain anonymous. You mail also send an email to lworley@nhcgov.com.

Social Services: 1650 Greenfield Street • Wilmington, NC 28401 • Phone 910-798-3400 • Fax 910-798-7824