PM13

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  • #33540
    ralph
    Participant

    PM 13 is the number of fraud referrals received.

    We’ve been looking at whether or not NFI & HBMS data matches should be included.

    In the PM Guide it refers us to the description for item 31 on Stats 124:
    [quote:7e5194fa90]Number of cases referred to the LA fraud/investigation section for further action, enter the total HB/CTB cases passed to your fraud section for investigation in the quarter. Include referrals by HB/CTB section staff, anonymous telephone calls and referrals from other agencies or individuals. [/quote:7e5194fa90]

    I’m tempted to say that [i:7e5194fa90]referrals from other agencies[/i:7e5194fa90] covers it.

    However Adelphi have said the following:
    [quote:7e5194fa90]Not all referrals from HBMS and NFI should automatically be counted in PM13. They should be first dealt with by non-fraud staff to establish whether the discrepancy highlighted can be resolved without a referral to the fraud team. If the benefit assessors are unable to resolve the discrepancy they may feel that a referral to the LA fraud/investigations team is appropriate. It is these referrals that should be counted for the purposes of PM13. [/quote:7e5194fa90]

    Our fraud section deal with all NFI referrals and data matches, and I’m loathe to change that and get an assessor to have to conduct any sort of filtering on them.

    As far as fraud are concerned everything they receive is treated as a referral and they decide whether or not they want to open an investigation.

    Does anyone filter NFI & HBMS matches as Adelphi are suggesting, or do people generally count all of them in PM13?

    #93162
    LouP
    Participant

    Our investigations team have advised that they don’t count NFI or HBMS referrals unless a true investigation is commenced, i.e. after preliminary enquiries have been made they feel there are grounds to commence a fraud investigation.

    #93163
    ralph
    Participant

    Thanks Lou

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