Reporting Potentially Fraudulent Activity
This section contains information regarding reporting inappropriate, suspicious, or potentially fraudulent activity.
Policy
To report potentially fraudulent activity, including inappropriate and suspicious activity, see https://des.az.gov/how-do-i/report-suspected-fraud.
Procedures
All instances where an employee, contractor, or volunteer is discovered or suspected of being involved in an inappropriate, suspicious, or potentially fraudulent activity must be reported.
All AZTECS, HEAplus, and OnBase(g) inquiries are recorded. Actions that display in a case in which there is a conflict of interest could be considered suspicious or potentially fraudulent activity.
Inappropriate, suspicious, or potentially fraudulent activity may be discovered while completing certain actions. Those actions include, and are not limited to, any of the following:
●Viewing employee, contractor, or volunteer activity on a case
●Registering or processing new or renewal applications
●Working alerts or processing changes
●Conducting case read activity
●Discussion with or overhearing a discussion among employees, contractors, or volunteers
●Information provided by a participant regarding their case or other cases
●Observing an employee, contractor, or volunteer viewing a case that they have no official business reason to access
●While conducting audits
A Division of Benefits and Medical Eligibility (DBME) employee, contractor, or volunteer must immediately verbally report any suspicious or potentially fraudulent activity to any of the following:
●Supervisor
●Office Manager
●Region Program Manager (RPM)
●Section Manager to include, and not limited to, any of the following:
Research and Analysis (R&A)
FAA Systems
DBME HR Operations
Employee Fraud Hotline
When the activity involves available physical evidence, the evidence must be secured and provided to appropriate management at the time the verbal report is made.
The employee, contractor, or volunteer must send an email after the verbal report to their direct Supervisor or Section Manager reporting the incident. The email must be sent no later than the first workday(g) following the verbal report and must include a description of the suspicious or potentially fraudulent activity.
Arizona Revised Statute §41-1959 makes the release of confidential information a Class 2 Misdemeanor. Disciplinary action is taken when it is found that an employee, contractor, or volunteer has misused or inappropriately released case information. Disciplinary action may include suspension, dismissal, and prosecution.Management Reporting Responsibilities for Suspicious or Fraudulent Activity
The Supervisor or Section manager must immediately report the suspicious or potentially fraudulent activity, to their Region Program Manager (RPM), Program Administrator, or other designated staff.
The email from the initiating employee to the office manager, supervisor, or other designated staff must be forwarded no later than the following workday(g) to the RPM or PA, copying the FAA Benefits Team Manager.
Any physical evidence provided by the initiating employee must be secured in a safe place until a direction is received. The office of the Program Administrator or the Assistant Director reviews the information and provides guidance to any of the following for additional or necessary actions required:
●RPM
●FAA office manager
●Section manager
●Designated staff
Legal Authorities
CFR 7 § 273.2(a)(1)
ARS 38-501 through ARS 38-511
ARS 41-1959
ARS 41-165E
last revised12/26/2023