OSI - Potential Fraud Referral Requirements
(01/01/18 – 12/31/18)
FAA offices may refer a participant for investigation when the participant is suspected of program violations and potential fraud exists.
Refer cases to Office of Special Investigation (OSI) for investigation based on any of the following situations:
Frequent changes in budgetary unit composition (moving in or out) and living arrangement
Newborn child with an absent parent (AP) and the participant claims no knowledge of the AP's whereabouts
Expenses consistently exceed reported income (See Expenses Exceed Income (EEI))
Participant’s residential or mailing address is questionable
Inconsistencies in the current application and the case file(g) that cannot be resolved by the FAA office
The participant’s contradictory verbal or written statements
When a QC-100 indicates potential fraud exists
Do not use an OSI referral for the following:
Medical only (MAO) cases
To verify information such as income, expenses, or budgetary unit composition.
Closed cases
Cases containing a homeless person using only a PO Box
To establish paternity
To verify when the household purchases and prepares food together or separately
Situations that do not affect benefit eligibility
Prior to submitting an OSI Investigation Referral, determine whether the referral should be sent to OSI. The DBME Referral Guide for OIG should be used to make this determination. The DBME Referral Guide for OIG is found in the FAA Policy Support SharePoint Site Doc Library. (Internal use only)
NOTE Referrals for investigation must support an allegation of potential fraud. OSI does not conduct verification investigations. The verification process must be used to verify mandatory verification factors.
Submit the OSI Investigation Referral via the DES Intranet when evidence of potential fraud exists and any of the following apply:
CA only case
NA only case
Case involves more than one program
(See OSI Investigation Referral for instruction on completing the referral form)