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The 193rd General Court of the Commonwealth of Massachusetts

Section 16V: Bureau of program integrity; members; duties and responsibilities

Section 16V. (a) There shall be within the executive office of health and human services, but not subject to the control of the office, a bureau of program integrity. The inspector general shall appoint a director of the bureau, who shall serve as an assistant inspector general, under the supervision of the inspector general, and shall serve for a term of 4 years. The inspector general may remove the director for cause and designate an interim director until a new director is appointed. The director shall devote full time and attention to the duties of this office.

(b) The director may appoint such persons as are necessary to perform the functions of the bureau; provided, however, that section 9A of chapter 30 and chapter 31 shall not apply to any person holding any such appointment. The director may appoint and remove, subject to the approval of the inspector general, such expert, clerical and other assistants as the work of the bureau may require. Employees shall devote their full-time and attention to their duties while employed with the bureau and shall be subject to the rules and regulations established for employees of the office of the inspector general pursuant to section 4 of chapter 12A.

(c) The bureau shall monitor the quality, efficiency and integrity of programs administered by the executive office of health and human services. The bureau shall seek to prevent, detect and correct fraud, waste and abuse in the expenditure of public funds for benefit programs including, but not limited to, MassHealth, transitional aid to families with dependent children, emergency assistance to elders, disabled and children, the supplemental nutrition assistance program and other assistance benefits distributed via electronic benefit cards.

(d) In addition to the responsibilities set forth in subsection (c), the bureau shall: (i) review current eligibility intake and determination procedures for public benefit programs administered by the office of health and human services; (ii) assist in the development of any new intake procedures and regulations for eligibility determination; (iii) monitor whether eligibility regulations are being followed by the administering agency; (iv) assist with the coordination with other state agencies to transmit and collect data on beneficiaries; (v) coordinate with the program integrity division under the department of transitional assistance; (vi) provide training to employees serving under the office of health and human services on methods of intake procedures and beneficiary determination; and (vii) automate reporting of indicators of potential fraud cases.

(e) The bureau shall coordinate and consult with the executive office of health and human services on the efforts to verify eligibility for recipients of benefit programs through the sharing of information with other agencies and departments, including but not limited to, the department of revenue, the department of elementary and secondary education, the department of unemployment assistance, the department of industrial accidents, the registry of motor vehicles, the department of criminal justice information services and the department of correction.

(f) The director may report and refer instances of fraud, waste or abuse of public benefits to the inspector general for investigation pursuant to section 8 of chapter 12A and the results of such investigation may be referred to the attorney general or state auditor for appropriate action.