Mass. Gen. Laws ch. 11, sec. 17 — MA Code / Part I / Title II / Chapter 11 / Section 17
Director; investigations; authority
Status: in_force

Section 17. The director shall initiate investigations and investigate complaints, including complaints initiated by recipients, which indicate the possibility of either a fraudulent claim for payment or services under any assistance program administered by the department of transitional assistance, the department of children and families, the division of medical assistance or any other program administered by said departments or the receipt of payment or services by a person not entitled thereto. The director, in conformity with the rules and regulations of the auditor, shall: (1) initiate investigations and review procedures in order to discover any fraudulent claim or wrongful receipt under any assistance program administered by the department of transitional assistance, the executive office of health and human services, in its capacity as the single state agency for the purposes of Title XIX of the Social Security Act or any program administered by the department of social services; (2) examine the records and accounts of the department of transitional assistance, department of children and families, the division of medical assistance, the division of industrial accidents, the state retirement board, the department of employment and training and the executive office of veterans' services and, for such purposes, the director shall have access to such records and accounts at reasonable times and may require the production of books, documents and vouchers relating to any matter within the scope of the investigation; (3) examine, upon written request to the commissioner of revenue, the tax returns, wage reports, papers or other documents on file with said commissioner, including information which appears in child support enforcement files maintained by the IV–D agency as set forth in chapter 119A concerning dates and amounts of income received, employer, last known address and other information relevant to the investigation of fraud concerning any person where there is reason to believe that such person has committed fraud under any assistance program administered by the department of transitional assistance, the executive office of health and human services, in its capacity as the single state agency for the purposes of Title XIX of the Social Security Act or the department of social services, and may require the production of such returns, reports, papers and other documents. Nothing herein shall be construed to authorize the examination or disclosure, directly or indirectly, of any information, returns or their records received from the Internal Revenue Service; (4) examine the records and accounts of any vendor claiming or receiving payment for services rendered under any program administered by the department of transitional assistance, the executive office of health and human services, in its capacity as the single state agency for the purposes of Title XIX of the Social Security Act or the department of social services insofar as such records and accounts relate to any matter within the scope of such investigation; (5) examine any information contained on the warrant management system established by section 23A of chapter 276 and receive information from the department of transitional assistance in accordance with clause (e) of the last paragraph of subsection (D) of section 2 of chapter 18; (6) report to the attorney general, a district attorney, the department of state police, or any of their agents, each case referred to the bureau of special investigations by the department of transitional assistance pursuant to said clause (e), and arrange for a proper place and time for the arrest of an applicant or beneficiary and refer any dependents of the applicant or beneficiary to the department of social services for appropriate action pursuant to chapter 18B and section 23A of chapter 119. The bureau shall not report any information other than the information referred to in this clause or on the warrant management system; (7) report to the attorney general or a district attorney, for such action as they may deem proper, any case in which, after investigation, he finds there is probable cause to believe that a fraudulent claim or payment has been made; (8) report in writing to the governor and the general court the nature and extent of his activities for each calendar year, the report to be made not later than 90 days after the expiration of the calendar year, which report shall be made available to the public. (9) examine the records and accounts of any person domiciled or doing business in the commonwealth and any state, county or municipal department, agency, office, bureau, board, commission or division which employs or had employed an individual who is the subject matter of an investigation insofar as those records and accounts pertain to dates, hours and nature of employment or services rendered and the amounts of salary, wages, or other things of value paid and deductions therefrom, including information concerning the prior employment history of the individual who is the subject matter of the investigation; (10) examine the records and accounts of any bank, as defined in section 1 of chapter 167, national bank, federal savings and loan association, benefit association, insurance company, safe deposit company or loan company authorized to do business in the commonwealth relative to individuals who are the subject matter of an investigation insofar as the records and accounts pertain to deposits, withdrawals, loans, insurance transactions, claims settlements and payments; (11) examine the student records of any school or institution of higher education within the commonwealth relative to a student who is the subject matter of an investigation or the child, ward or dependent of the subject matter of an investigation insofar as those records pertain to enrollment, attendance, and family history but excluding academic, medical, and evaluative records; and (12) a written request of the director, or of an authorized representative of the director, for examination of information, records or accounts as provided in clauses (4), (9), (10) and (11) shall be complied with within a reasonable period of time. (13) be authorized, in any investigation conducted pursuant to this section, to utilize the lien provisions set forth in section 29 of chapter 18. Nothing in this section shall be construed as extending the audit authority of the auditor.

Section 17. The director shall initiate investigations and investigate complaints, including complaints initiated by recipients, which indicate the possibility of either a fraudulent claim for payment or services under any assistance program administered by the department of transitional assistance, the department of children and families, the division of medical assistance or any other program administered by said departments or the receipt of payment or services by a person not entitled thereto. The director, in conformity with the rules and regulations of the auditor, shall:

(1) initiate investigations and review procedures in order to discover any fraudulent claim or wrongful receipt under any assistance program administered by the department of transitional assistance, the executive office of health and human services, in its capacity as the single state agency for the purposes of Title XIX of the Social Security Act or any program administered by the department of social services;

(2) examine the records and accounts of the department of transitional assistance, department of children and families, the division of medical assistance, the division of industrial accidents, the state retirement board, the department of employment and training and the executive office of veterans' services and, for such purposes, the director shall have access to such records and accounts at reasonable times and may require the production of books, documents and vouchers relating to any matter within the scope of the investigation;

(3) examine, upon written request to the commissioner of revenue, the tax returns, wage reports, papers or other documents on file with said commissioner, including information which appears in child support enforcement files maintained by the IV–D agency as set forth in chapter 119A concerning dates and amounts of income received, employer, last known address and other information relevant to the investigation of fraud concerning any person where there is reason to believe that such person has committed fraud under any assistance program administered by the department of transitional assistance, the executive office of health and human services, in its capacity as the single state agency for the purposes of Title XIX of the Social Security Act or the department of social services, and may require the production of such returns, reports, papers and other documents. Nothing herein shall be construed to authorize the examination or disclosure, directly or indirectly, of any information, returns or their records received from the Internal Revenue Service;

(4) examine the records and accounts of any vendor claiming or receiving payment for services rendered under any program administered by the department of transitional assistance, the executive office of health and human services, in its capacity as the single state agency for the purposes of Title XIX of the Social Security Act or the department of social services insofar as such records and accounts relate to any matter within the scope of such investigation;

(5) examine any information contained on the warrant management system established by section 23A of chapter 276 and receive information from the department of transitional assistance in accordance with clause (e) of the last paragraph of subsection (D) of section 2 of chapter 18;

(6) report to the attorney general, a district attorney, the department of state police, or any of their agents, each case referred to the bureau of special investigations by the department of transitional assistance pursuant to said clause (e), and arrange for a proper place and time for the arrest of an applicant or beneficiary and refer any dependents of the applicant or beneficiary to the department of social services for appropriate action pursuant to chapter 18B and section 23A of chapter 119. The bureau shall not report any information other than the information referred to in this clause or on the warrant management system;

(7) report to the attorney general or a district attorney, for such action as they may deem proper, any case in which, after investigation, he finds there is probable cause to believe that a fraudulent claim or payment has been made;

(8) report in writing to the governor and the general court the nature and extent of his activities for each calendar year, the report to be made not later than 90 days after the expiration of the calendar year, which report shall be made available to the public.

(9) examine the records and accounts of any person domiciled or doing business in the commonwealth and any state, county or municipal department, agency, office, bureau, board, commission or division which employs or had employed an individual who is the subject matter of an investigation insofar as those records and accounts pertain to dates, hours and nature of employment or services rendered and the amounts of salary, wages, or other things of value paid and deductions therefrom, including information concerning the prior employment history of the individual who is the subject matter of the investigation;

(10) examine the records and accounts of any bank, as defined in section 1 of chapter 167, national bank, federal savings and loan association, benefit association, insurance company, safe deposit company or loan company authorized to do business in the commonwealth relative to individuals who are the subject matter of an investigation insofar as the records and accounts pertain to deposits, withdrawals, loans, insurance transactions, claims settlements and payments;

(11) examine the student records of any school or institution of higher education within the commonwealth relative to a student who is the subject matter of an investigation or the child, ward or dependent of the subject matter of an investigation insofar as those records pertain to enrollment, attendance, and family history but excluding academic, medical, and evaluative records; and

(12) a written request of the director, or of an authorized representative of the director, for examination of information, records or accounts as provided in clauses (4), (9), (10) and (11) shall be complied with within a reasonable period of time.

(13) be authorized, in any investigation conducted pursuant to this section, to utilize the lien provisions set forth in section 29 of chapter 18.

Nothing in this section shall be construed as extending the audit authority of the auditor.