Welfare Fraud investigations are mandated by the State of California within the Welfare and Institutions Code Sections for the protection of Welfare funds. Welfare fraud is prosecuted under Welfare and Institutions Code Section 10980. In the absence of special sections within the Welfare and Institution Code, welfare fraud is prosecuted under Penal Code Section 487 (Grand Theft), Penal Code Section 72 (Presentation of fraudulent claim), Penal Code Section 118 (Perjury) and Penal Code Section 182 (Conspiracy).
Reporting Welfare Fraud
Cases are first received by the Welfare Fraud Unit. If you believe you may have witnessed welfare fraud, which is considered a crime, you may contact the Welfare Fraud Unit, located within the San Benito County Health and Human Services Agency. Please call (831) 630-5125 to speak with the Welfare Fraud Staff and file a report. Reports can be made anonymously, if necessary. If you would like to report fraud in another county, CLICK HERE
A complete and detailed referral should be made to the Fraud Unit when there are reasonable grounds to suspect that a crime, such as fraud, perjury, embezzlement, trafficking, etc., against a public social services program has been committed.
Be prepared to give details on:
- Children’s names and ages
- An explanation of the fraudulent circumstances
- Approximate time period of crime committed.
What is Welfare Fraud?
Fraud exists when a person, on behalf of himself or others has:
- Knowingly (with the intent to deceive or defraud) made a false statement or representation to obtain public assistance benefits, obtain continuous or increase in these benefits, or avoid a reduction of public assistance benefits.
- Knowingly (with the intent to deceive or defraud) failed to disclose a fact, which, if disclosed, could have resulted in the denial, reduction, or discontinuance of benefits.
- Accepted benefits knowing he/she is not entitled to, or accepted any amount of benefits knowing it is greater than the amount to which he/she is entitled.
- Made statements, which he/she did not know to be true, with reckless regard for the truth, for the purpose of obtaining, continuing, or avoiding a reduction or denial of public assistance benefits.
- CalFresh trafficking (food stamp trafficking) is the attempt to or actual selling or purchasing of CalFresh benefits and/or items purchased with CalFresh benefits.
After a Report is Made
Cases of suspected fraud are evaluated by the San Benito County Welfare Fraud Unit. If public assistance over payments are determined, repayment arrangements are established. These cases may also be referred to the San Benito County District Attorney’s Office for consideration of prosecution. Approximately $65,000 is recovered and repaid each year, as a result of Welfare Fraud investigation activities. We do prosecute Welfare Fraud in San Benito County.
Reporting Medi-Cal Fraud
The Department of Health Care Services (DHCS) asks that anyone suspecting Medi-Cal fraud, waste, or abuse to call the DHCS Medi-Cal Fraud Hotline: (800) 822-6222. Our recorded message may be heard in English and four other languages: Spanish, Vietnamese, Cambodian, and Russian. The call is free and the caller may remain anonymous. Report Medi-Cal fraud (administered by the California Department of Health Services). You can also call about Medi-Cal Beneficiary Fraud and Abuse at: 800-222-2662
Reporting Other Types of Fraud
- In Home Support Services (IHSS) Fraud Hotline: (888) 717-8302 or DHCS A&I Fraud Referrals.
- Administration (SSA), Office of the Inspector General (OIG), Fraud Hotline provides an avenue for reporting fraud, waste, and abuse within SSA’s programs and operations.
- Provider Fraud and Elder Abuse complaint line: (800) 722-0432