Dáil Éireann Debate, Thursday - 2 June 2022
302. Deputy Gary Gannon asked the Minister for Social Protection further to Parliamentary Question No. 589 of 22 March 2022, if she will provide further information regarding the rules-based approach to reviews; when this approach was initiated in her Department; the approach that existed prior to the rules-based approach; and if she will make a statement on the matter. [28802/22]
Amharc ar fhreagraAs part of its efforts to prevent and detect social welfare fraud, the Department has always had a process of conducting reviews of claims in payment. Cases for review of entitlement may be selected on a random or risk-based basis, or where specific information comes to the attention of the Department, for example, through inspection of employer records, inspections of places of employment or on receipt of good citizen reports.
More broadly, reviews may consist of desk-based assessments of customer claims or face-to-face interviews with customers by trained investigators, audits of employers’ PRSI records, specialist investigations, enquiries with other state agencies, self-declarations by customers or joint operations with the Revenue Commissioners.
The rules-based approach to reviews selects a claim for review of entitlement which has regard to the eligibility rules governing a particular scheme. The rules-based approach is effectively based on risk-based criteria such as checking with Revenue real-time data records on earnings, duration of a claim in payment, the length of time since a review was last conducted, and whether there is verified documentation associated with the claim.
This rules-based approach has been in operation since 2016 and has worked alongside rather than replaced pre-existing review measures. Prior to the introduction of the rules-based approach a larger percentage of cases relied on random selection of cases combined with traditional approaches to case selection, such as customer requested reviews, control surveys (random selection of up to 1,000 claims on a particular scheme for review), notifications of changes in circumstances by customers and reported suspected fraud by members of the public.
I hope this clarifies the matter for the Deputy.
