Finding 1164527 (2022-001)

Material Weakness Repeat Finding
Requirement
E
Questioned Costs
$1
Year
2022
Accepted
2025-12-11
Audit: 374110
Organization: State of South Carolina (SC)

AI Summary

  • Core Issue: The Agency's internal controls for determining eligibility for unemployment benefits were inadequate, leading to increased fraudulent claims due to expedited fund distribution during the pandemic.
  • Impacted Requirements: The Agency did not fully comply with federal and state guidelines for eligibility determinations and internal controls, increasing the risk of fraud.
  • Recommended Follow-Up: The Agency should enhance and monitor eligibility procedures and implement stronger internal controls to prevent future fraudulent claims.

Finding Text

Finding 2022-001: Unemployment Insurance Benefit Payments (Material Weakness in Internal Controls) Condition: In March 2020, the President signed the CARES Act that authorized additional funding under the Unemployment Insurance (UI) program. This was followed by additional federal and state funding programs that increased grants available and modified eligibility requirements to support changes in employment status caused by the COVID-19 pandemic. Certain benefits under these programs extended into fiscal year 2022. There was a priority on distributing funds under self-attestation strategy with limited income verification to expedite disbursement of funds and support individuals in greatest need. As a result of this, many states saw a significant increase in fraudulent claims to historical highs. The U.S. Department of Labor and the Agency have partnered to investigate the extent and methods used to perpetrate fraud. For the Agency, eligibility determinations made by the management followed existing policies and procedures for this pandemic funding; however, to meet federal and state expectations regarding the quick payment of federal pandemic benefits, the policies and procedures in place were not the usual policies and procedures and so they were not adequate to completely prevent fraudulent claims. The Agency’s detective controls did identify abnormal claim activity; however, it was after the claims had already been paid. During our testing of a sample of 60 benefit payments we identified 3 payments that were fraudulent, total value of payments tested was $16,776 and total amount of fraud was $835. The extrapolated fraud amount over the total benefit payments of $179.4 million would be $9 million. Criteria: Per 2 CFR §200 Appendix XI, state responsibilities include: (1) establishing specific, detailed policies and operating procedures which comply with the requirements of federal laws and regulations; (2) determining the state unemployment insurance tax structure; (3) collecting state unemployment insurance contributions from employers (commonly called “unemployment taxes”); (4) determining claimant eligibility and disqualification provisions; (5) making payment of UI benefits to claimants; (6) managing the program’s revenue and benefit administrative functions; (7) administering the programs in accordance with established policies and procedures; and (8) enacting state UC law that conforms with federal UC law and that state law and operations substantially comply with federal law. Effect: A lack of adequate internal controls over eligibility determinations may increase the likelihood of fraudulent claims being submitted and incorrectly paid. Known Questioned Costs: During our testing of a sample of 60 benefit payments we identified 3 payments that were fraudulent, the total value of payments tested was $16,776 and total amount of known fraud was $835. Likely Questioned Costs: Based upon the extrapolated fraud amount over the total benefit payment of $179.4 thousand the total amount of fraud would likely be $10 million. Cause: The Agency experienced unprecedented claims volume starting in fiscal 2021 and continuing into fiscal year 2022 with increased funding and additional program requirements with a priority for efficient distribution from both the U.S. Department of Labor and state officials. Recommendation: We recommend that the Agency continue to review, monitor, and enhance eligibility procedures to detect and/or prevent fraudulent claimants from receiving benefits. The Agency should work to enhance and update its assessment of risks related to the eligibility process and implement internal controls to help mitigate future fraudulent claims.

Corrective Action Plan

The South Carolina Department of Employment and Workforce (SCDEW) immediately recognized the increased fraud risk presented by the federal pandemic programs. In an effort to deter this obvious fraud threat, SCDEW initially informed every applicant for federal pandemic benefits that they might be required to provide proof of their employment or self-employment at a future time. The USDOL, however, ordered SCDEW to remove this notification because, in the words of one USDOL representative, such a warning might deter a claimant from applying for federal pandemic benefits. USDOL subsequently issued guidance prohibiting states from requiring proof of employment or self-employment as an eligibility requirement to receive federal pandemic benefits. Therefore, all a fraudster had to do to receive federal benefits was simply tell a state they were unemployed as a result of the COVID-19 pandemic. SCDEW was prohibited from requiring that fraudster to prove that they were even employed, let alone that they were unemployed because of the pandemic. Many of the items identified as paid fraudulent claims were caused by SCDEW’s compliance with the USDOL guidelines. SCDEW complied with this guidance, even though it disagreed with USDOL’s highly technical parsing of federal law, and SCDEW advocated for Congress to amend the law to clearly establish commonsense fraud protections. While awaiting Congressional action, SCDEW implemented numerous fraud detection and prevention tools and strategies to minimize the potential fraud exacerbated by lax federal requirements. Unfortunately, Congress did not amend the law until late December 2020. As a result, eligibility determinations made by SCDEW prior to the law change followed the federal guidance for this pandemic funding; however, to meet federal and state expectations regarding the quick payment of federal pandemic benefits, the federal policies and procedures SCDEW was forced to adopt were not adequate to completely prevent fraudulent claims. SCDEW continues to review, monitor, and enhance eligibility processes and procedures to prevent and detect fraudulent claims. We also updated our internal controls to help mitigate future fraudulent claims. The COVID pandemic created unprecedented challenges for every state workforce agency due to the combination of historic claim volume, the availability of a staggering amount of federal money, and new programs with lax eligibility and verification requirements that had to be implemented quickly, despite often changing federal guidance. These factors created a perfect storm for sophisticated fraudsters to exploit. In response, SCDEW took numerous aggressive steps. In mid-2020, SCDEW required applicants to provide copies of their driver’s license or passport to prove their identity before receiving benefits. SCDEW also implemented identity verification questions through Lexis Nexis that every claimant had to pass before processing a claim. This was further enhanced in March 2021, when South Carolina was one of the first states to implement digital identity verification through ID.me. SCDEW also implemented reCAPTCHA to prevent against bot attacks, implemented new data sharing agreements, and increased the number of staff dedicated to investigating fraudulent claim activity to over fifty at the peak of the pandemic programs. SCDEW continuously reviews its fraud detection and prevention activities to stay ahead of emerging fraud schemes. Since the height of the pandemic, SCDEW has increased its data crossmatching, partnered with the State Law Enforcement Division to have a financial fraud investigator dedicated to unemployment insurance fraud, and made numerous enhancements to its computer systems to combat fraud and preserve the integrity of the unemployment insurance system. Per USDOL data, the agency had the twelfth lowest improper payment rate out of fifty-three programs during the year ending September 30, 2024. For more comprehensive explanation and response, please see August 26, 2024, letter attached from Paul Famolari, Assistant Executive Director of Unemployment Insurance. The Agency’s contact person responsible for the corrective action plan is Jacquelyn Carlen, CFO. The completion date of the corrective action plan was June 20, 2021, and is ongoing.

Categories

Questioned Costs Eligibility Material Weakness Internal Control / Segregation of Duties Special Tests & Provisions

Other Findings in this Audit

  • 1164526 2022-001
    Material Weakness Repeat
  • 1164528 2022-003
    Material Weakness Repeat
  • 1164529 2022-003
    Material Weakness Repeat
  • 1164530 2022-002
    Material Weakness Repeat
  • 1164531 2022-002
    Material Weakness Repeat
  • 1164532 2022-002
    Material Weakness Repeat
  • 1164533 2022-002
    Material Weakness Repeat
  • 1164534 2022-002
    Material Weakness Repeat
  • 1164535 2022-002
    Material Weakness Repeat
  • 1164536 2022-002
    Material Weakness Repeat
  • 1164537 2022-002
    Material Weakness Repeat
  • 1164538 2022-002
    Material Weakness Repeat
  • 1164539 2022-002
    Material Weakness Repeat
  • 1164540 2022-002
    Material Weakness Repeat
  • 1164541 2022-002
    Material Weakness Repeat
  • 1164542 2022-002
    Material Weakness Repeat
  • 1164543 2022-002
    Material Weakness Repeat
  • 1164544 2022-002
    Material Weakness Repeat

Programs in Audit

ALN Program Name Expenditures
17.225 UNEMPLOYMENT INSURANCE $49.91M
17.278 WIOA DISLOCATED WORKER FORMULA GRANTS $13.12M
17.258 WIOA ADULT PROGRAM $10.90M
17.259 WIOA YOUTH ACTIVITIES $9.73M
17.207 EMPLOYMENT SERVICE/WAGNER-PEYSER FUNDED ACTIVITIES $8.88M
17.801 JOBS FOR VETERANS STATE GRANTS $1.54M
17.804 LOCAL VETERANS' EMPLOYMENT REPRESENTATIVE PROGRAM $1.33M
17.002 LABOR FORCE STATISTICS $988,995
17.245 TRADE ADJUSTMENT ASSISTANCE $933,778
17.271 WORK OPPORTUNITY TAX CREDIT PROGRAM (WOTC) $451,540
12.617 ECONOMIC ADJUSTMENT ASSISTANCE FOR STATE GOVERNMENTS $369,493
17.273 TEMPORARY LABOR CERTIFICATION FOR FOREIGN WORKERS $217,216
17.277 WIOA NATIONAL DISLOCATED WORKER GRANTS / WIA NATIONAL EMERGENCY GRANTS $132,777
17.270 REENTRY EMPLOYMENT OPPORTUNITIES $5,144