Labor IG Issues Memorandum on ETA Needs to Incorporate Data Analytics Capability to Improve Oversight of the Unemployment Insurance Program
Here are excerpts:
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MEMORANDUM FOR:
FROM:
SUBJECT: Alert Memorandum: ETA Needs to Incorporate Data Analytics Capability to Improve Oversight of the Unemployment Insurance Program; Report Number: 19-23-012-03-315
The purpose of this memorandum is to alert the
This memorandum builds on our previous work, identifying additional risk within state UI claims data for agency action.
We are concerned ETA currently does not have direct access to state UI claims data. Additionally, we are concerned ETA does not have the capability to analyze said data, which would allow it to better identify fraud and other improper payments, as well as other trends or emerging issues, such as timeliness or equity.
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1 Alert Memorandum: Potentially Fraudulent Unemployment Insurance Payments in High-Risk Areas Increased to
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To provide relief to American citizens experiencing pandemic-related employment issues and challenges, the Coronavirus Aid, Relief, and Economic Security Act and subsequent legislation authorized seven new temporary UI programs./2
These temporary pandemic-related UI programs, coupled with the state UI programs, paid
For more than 20 years, the OIG has reported on the
GAO subsequently added the UI system to its "High Risk List" and recommended that DOL develop a plan for transforming this system./4
In 2023, GAO estimated the pandemic related fraud rate for the UI programs was about 11 to 15 percent for the period
GAO also noted that the full extent of UI fraud during the pandemic will likely never be known with certainty.
The improper payment rate estimate for the UI program, as reported to the
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2 These new programs included the Pandemic Unemployment Assistance program, which extended UI benefits to individuals not traditionally eligible; the Federal Pandemic Unemployment Compensation program, which provided supplemental payments to individuals receiving traditional and other eligible UI benefits; and the Pandemic Emergency Unemployment Compensation program, which provided up to an additional 13 weeks of unemployment compensation to individuals who exhausted their regular UI benefits.
3 GAO, COVID-19: Sustained Federal Action is Crucial as Pandemic Enters Its Second Year, Report No. GAO-21-387 (
4 GAO,
5 GAO,
6 The improper payment reporting year is the 12-month period ending
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In 2021 and 2022, ETA estimated an improper payment rate of 18.71 percent and 21.52 percent, respectively. Further, ETA estimated a fraud rate of 8.57 for 2021--a 170 percent increase over the prior year's fraud rate of 3.17 percent./7
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Figure 1: UI Improper Payment Rates, 2004 - 2022/8
Source: OIG analysis of improper payment data published by ETA
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During our previous audit/9 of DOL's response to the UI program's expansion under the Coronavirus Aid, Relief, and Economic Security Act, we performed comprehensive data analyses on state UI claims data for
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7 ETA estimated the fraud rate as part of its Benefit Accuracy Measurement program for the period
8 The 2020 improper payment rate of 9.7 percent was calculated based on 9 months of data, from
9 COVID-19: States Struggled to Implement CARES Act Unemployment Insurance Programs, Report No. 19-21-004-03-315 (
10 Alert Memorandum: The
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Our subsequent analyses of those high-risk areas, using UI claims data through
We provided ETA with our underlying methodology as well as specific claimant information, and ETA shared the information with states for appropriate action. We are currently performing four separate audits to examine the extent to which ETA and states have taken action on a sample of potentially fraudulent claims in each of the four high-risk areas.
Since our earlier analyses, we have identified almost
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Table 1: UI Pandemic Benefits Paid to High-Risk Age Groups,
Source: OIG data analysis of state UI claims data
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Although these could be legitimate claims, they merit additional oversight and scrutiny as workers typically do not fall into these age categories. For example, the Fair Labor Standards Act of 1938 sets a minimum age of 14 for employment in non-agricultural occupations covered by the act, which effectively limits employment for children under 14 to work that is exempt from the act, such as delivering newspapers and acting.
In addition to the potential fraud risk inherent with children under 14 receiving UI benefits, there is a risk and concern that these children could be victims of child labor exploitation. Since 2018, DOL has seen a 69 percent increase in children being employed illegally by companies. In Fiscal Year (FY) 2022, DOL found 835 companies it investigated had employed more than 3,800 children in violation of labor laws. The OIG is planning to do audit work in this area - which falls under the purview of DOL's Wage and Hour Division - in the future.
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11 Alert Memorandum: Potentially Fraudulent Unemployment Insurance Payments in High-Risk Areas Increased to
12 To prevent double counting, these results do not include any claims identified in our analyses of the four high-risk areas covered by our previous alert memoranda.
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Further, while there are no legal restrictions placed on elderly workers, it is rare for individuals over the age of 100 to be in the workforce. The
Our analysis identified four states that paid UI claims to 18 percent or more of individuals aged 100 years or older from
If these claims were legitimate, this would indicate a remarkably large percentage of centenarians were still working and eligible for UI benefits in these four states - a trend that was not observed in other states. For example, the
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Figure 2: Percentage of Persons 100 Years of Age or Older with UI Pandemic Benefits Paid from
Source: OIG data analysis of state UI claims data and 2020 U.S. Census data
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13
14 For this comparison, we used state population data sourced from the 2020 U.S. Census.
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Due to the results of our analysis in these two high-risk areas, we remain concerned about the amount of benefits paid in the aforementioned age groups. Further, our latest analysis brings the cumulative total amount of potentially fraudulent payments to more than
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Figure 3: Six High-Risk Areas for Potential UI Fraud Identified by the OIG
Source: OIG data analysis of state UI claims data
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In "A Framework for Managing Fraud Risks for Federal Programs," GAO recommends using data analytic tools and techniques to prevent and detect fraud. It states:
'Data analytics activities can include a variety of techniques to prevent and detect fraud. For example, data mining and data-matching techniques can enable programs to identify potential fraud or improper payments that have already been awarded, thus assisting programs in recovering these dollars, while predictive analytics can identify potential fraud before making payments.'/17
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15 Total amounts for these analyses do not include duplicates that were identified in one or more areas.
16 Of the more than
17 Appendix III in the GAO's "A Framework for Managing Fraud Risks in Federal Programs," Report No. GAO-15-593SP (
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In addition, the
According to ETA, it has developed a preliminary draft of a UI Fraud Risk Profile to align DOL's ongoing fraud risk management activities with GAO's Fraud Risk Framework. ETA also issued guidance in
ETA's FY 2023 Agency Management Plan states that improving overall program integrity in the UI program is one of the agency's top priorities. Strategy 3.2, "Strengthen Program Integrity by Preventing and Detecting Fraud, and Reducing Improper Payments," indicates that ETA will continue to "promote UI program integrity actively and aggressively by identifying and reducing fraud, waste, and abuse in the program." One of the activities for this strategy is to "invest in technology and data analytics," and specifically:
'Invest in tools and strategies to help states verify [the] identity of UI claimants, promote states' use of these tools/strategies, and perform data analytics to prevent and detect fraud, and reduce investigations backlog. These tools and strategies will be balanced to ensure equitable access and delivery of UI services.'
Another activity identified in ETA's FY 2023 Agency Management Plan is to work with the UI Integrity Center "to promote the consistent use of the Integrity Data Hub (IDH) by states to cross-match with all available datasets and promote the UI Integrity Center's Integrity Knowledge Exchange as a resource for program integrity information, tools (including a data analytics tool), and promising practices to states."
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18 Payment Integrity Alert: The Use of Automation and Data Analytics From the
19 Unemployment Insurance Program Letter No. 22-21, Change 2, available at: https://www.dol.gov/agencies/eta/advisories/uipl-22-21-change-2
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The UI Integrity Center is a joint federal-state initiative funded by DOL and operated by the
While tools and resources like the IDH can improve program integrity and increase detection and prevention of improper payments, including fraudulent payments, there are significant limitations. First, while ETA encourages states to use the tools available from the UI Integrity Center, ETA maintains that it lacks the authority to require states to participate. To this end, the OIG previously recommended in our first high-risk alert memo,/21 issued in
We also found the IDH is limited in its effectiveness in identifying potential improper payments and fraud. We recently reported that the IDH was not able to identify the same amount of potentially improper multistate claims when compared to the OIG's analysis./22 The IDH used a threshold that was higher than what the OIG would use to flag improper multistate claims. However, even when we used the IDH's threshold, we found the IDH only identified 39.7 percent of potential improper multistate claims using data from
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20
21 Alert Memorandum: The
22 COVID-19 - ETA Can Improve its Oversight to Ensure Integrity over CARES Act UI Programs, Report No. 19-23-011-03-315 (
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Finally, even without these limitations, the tools and resources do not relieve ETA from its program oversight responsibilities. ETA has recognized the critical importance of data analytics in detecting and preventing improper payments, including fraud, and improving program integrity. To this end, ETA has invested in providing states with tools through the UI Integrity Center and encouraged states to use data analytics to strengthen program integrity. However, ETA does not have direct access to UI claims data, nor has it developed its own data analytics capability at the federal level as part of its oversight of the UI program.
In its FY 2023 and FY 2024 Congressional Budget Requests for
ETA officials indicated the noted language in its Congressional Budget Requests was included as a component of future UI reform, but it would require statutory authority allowing access to the data, a new records management system, and individual data sharing agreements with states. Because this would take a significant increase in funding and years to plan and achieve, ETA indicated it is focusing its energies and resources on improving integrity controls in the federal-state partnership that reflect the current UI program, such as investing in enhancements to, promoting increased states participation in, and conducting evaluations of the IDH.
Although ETA has stated it needs additional authority to obtain access to state UI claims data, current federal regulations provide such authority for purposes described in this memorandum. Specifically, 20 C.F.R. Sec. 603.6 (a) states that "the
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23 FY 2023 Congressional Budget Justification for
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Conclusion
Ready access to UI claims data from all states and territories would enable ETA to ensure proper administration and provide sufficient oversight of the UI program.
Further, in addition to the tools and resources it provides to the states for fraud detection, such as the IDH, establishing a data analytics capability with a dedicated team of data scientists at the federal level would allow ETA to monitor and analyze UI claims data on an on-going basis. ETA would then be able to identify high-risk areas across multiple states and quickly flag potentially fraudulent claims that can be referred to the OIG and states for further action, which could help prevent future losses to fraudsters. Likewise, incorporating a data analytics capability into its program oversight function would improve ETA's ability to detect trends and emerging issues that could negatively impact the timeliness or equity of UI payments--before the issues grow into critical problems.
Ultimately, a data access and analytics capability would allow ETA management to make better informed decisions about the UI program and help mitigate the risk of improper payments including fraud, while also preparing ETA for future emergency UI programs where hundreds of billions in federal dollars could be at risk.
Recommendations
We recommend the Principal Deputy Assistant Secretary for Employment and Training:
1. Obtain direct access to unemployment insurance claims data from all state workforce agencies.
2. Create an integrity program that incorporates a data analytics capability and regularly monitors state unemployment insurance claims data to detect and prevent improper payments, including fraudulent payments, and to identify trends and emerging issues that could negatively impact the unemployment insurance program.
3. Establish effective controls, in collaboration with state workforce agencies, to mitigate fraud and other improper payments to ineligible claimants in high-risk age categories.
Summary of ETA's Response
On
For Recommendation 1, ETA stated that it lacks resources to develop a data warehouse that would be required to implement this recommendation. For Recommendation 2, ETA stated that developing a data analytics capability at the federal level would duplicate DOL's ongoing investment in the UI Integrity Center, including the IDH. To address these two recommendations, ETA suggested an alternative approach of working with the UI Integrity Center to improve IDH data analytics capabilities to better identify fraud trends. This would include meeting regularly with the UI Integrity Center to receive information about identified fraud trends and to discuss efforts to mitigate fraud and reduce improper payments.
ETA raised two additional concerns with our alert memorandum, related to our analyses of payments to elderly individuals 100 years of age or older and ETA's legal authority to access state UI claims data.
First, ETA indicated that one of the four outlier states we identified in our analysis had manipulated the date of birth field in the process of creating "pseudo records" for previously identified fraudulent claims. This was done in accordance with ETA guidance to ensure victims of fraud were not unfairly prevented from accessing benefits. According to ETA, 90 percent of the claims we identified for this state were "pseudo records" and not actual payments to individuals 100 years of age or older. ETA also stated that "it advised the OIG of this information and...is disappointed that the OIG did not include this context in the draft alert memorandum...."
Second, ETA raised a concern that the alert memorandum exaggerates DOL's legal authority to obtain data from states. Specifically, ETA stated it can only require the states to disclose claims information that is necessary for the proper administration of the program, and it cannot require states to provide DOL access to all claims data.
OIG Response to ETA Management Comments
For Recommendation 1, the OIG recognizes the resource concerns expressed by ETA and acknowledges there may be other ways that ETA can initially obtain direct access to state UI claims data. For example, with a more complete and consistent data set, the data maintained by the UI Integrity Center could be a potential source for this data until such a time that ETA can allocate funding to establish its own data warehouse.
For Recommendation 2, the OIG disagrees that developing a data analytics capability at the federal level would be a duplicative effort. As we noted in our memorandum, data analytics is an essential tool for program oversight - which is ETA's responsibility - that would allow ETA to improve its detection and prevention of improper payments, including fraud, perpetrated across multiple states, while also preparing ETA for future emergency UI programs where federal money could be at risk.
In relation to ETA's suggested alternative approach, while the suggested actions would likely benefit the UI program, this approach appears to continue shifting program oversight responsibilities to the states and the UI Integrity Center. We noted in our memorandum that states are not required to participate in the IDH, and those that do participate do so to varying degrees--which has limited the IDH's effectiveness. However, even if these limitations were resolved, it would not relieve ETA from its program oversight responsibilities. As such, ETA's suggested alternative approach would not alone meet the intent of the OIG's recommendations.
In relation to the additional concern on our analysis of claims paid to claimants 100 years of age or older, the OIG acknowledged in our memorandum that these claims could be legitimate but they required additional oversight and scrutiny. ETA did not notify us that the claims data contained "pseudo records" with altered dates of birth until it provided that information in its response to our draft memorandum.
Additionally, ETA did not provide us with evidence to support its statement that 90 percent of the claims the OIG identified for this state were "pseudo records." If accurate, this state paid UI claims to 5.9 percent of its centenarians, which was almost 5 times higher than the average of the 46 non-outlier states. The OIG stands by our assertion that all claims paid in high-risk age categories require additional oversight and scrutiny.
We further note that the UI program has experienced historic levels of improper payments. The OIG has issued multiple alert memoranda identifying tens of billions of dollars in potentially fraudulent UI payments identified through our use of data analytics. In addition, GAO recently reported that up to
In relation to DOL's legal authority to obtain data from states, the OIG did not recommend ETA acquire unnecessary data but rather, we recommended ETA obtain direct access to UI claims data from all states to improve the accuracy and reliability of results when performing data analytics and oversight of the UI program. ETA should access data that is necessary for, and relevant to, program administration and oversight.
We consider Recommendations 1 and 2 as open and unresolved. For Recommendation 1, ETA should obtain access to the data, ideally developing its own data warehouse; however, until ETA receives sufficient funding, it may be able to obtain access via the UI Integrity Center. For Recommendation 2, ETA should not rely totally on the
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The memorandum is posted at: https://www.oig.dol.gov/public/reports/oa/2023/19-23-012-03-315.pdf
Labor IG: 'COVID-19 – ETA Needs a Plan to Reconcile & Return to U.S. Treasury Nearly $5 Billion Unused by States for a Temporary Unemployment Insurance Program'
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