Benefits of Adding Workers’ Compensation Data to the Public Assistance Reporting Information System (PARIS)

 

How Workers’ Compensation cases submitted to PARIS might provide further value to PARIS Member States by reducing both Public Assistance Program Costs and State-Run Workers’ Compensation Programs

 

By

Carl Hammersburg

Fraud Detection Manager

Washington State Department of Labor & Industries

(360) 902-5933 / HAMC235@lni.wa.gov

Adding Workers’ Compensation Information to PARIS

 

 

This paper provides an overview of basic information States will require if they wish to add Workers’ Compensation data to the Public Assistance Reporting Information System (PARIS).   In the majority of cases, both public assistance agencies and State Workers’ Compensation systems will mutually benefit by such action.

 

What is PARIS?

 

PARIS is a computer matching process by which the Social Security Numbers of public assistance recipients are matched against various Federal databases and data from participating States.  PARIS is operated under the auspices of the Administration for Children and Families (ACF), U.S. Department of Health and Human Services

 

The PARIS Basics

 

PARIS provides three different computer matches in one data exchange - Federal, Veterans Affairs (VA) and Interstate focusing on five programs:

1. TANF,
2. Medicaid,
3. Food Stamps,
4. *Child Care,
5. *Workers’ Comp

* Added to the PARIS match in August 2007

 

Note: General Assistance and SSI (MA) cases are also included in the data exchange. 

 

State workers’ compensation data is added when PARIS Member States voluntarily choose to provide such data. PARIS matches are conducted quarterly  (Feb, May, August and November).  The match is based on a key indicator – the Social Security Number.  The principal purpose of the PARIS data exchange is to aid program integrity and provide States “red flags” for potential fraud detection.

 

The Legal Stuff

 

The ACF obtains Computer Matching Act clearance every 30 months.  A Memorandum of Agreement must be signed by a State and only those States may participate in the PARIS Match.  When the quarterly PARIS submission is due, each Member State decides to what degree they will participate (how many programs they want to submit, which databases they want to match against, and which public assistance clients they want to include).  There is no cost for States to participate in the data exchange other than the resources needed to utilize the specified PARIS formats and any follow-up necessary after the match results are retuned to the State.   

 

Who Uses PARIS?

Currently, 44 jurisdictions have joined PARIS. They are:

 

 

The Federal Role

 

The Administration for Children and Families (ACF) is the central point of contact for PARIS.  A Board of Directors has been established to work in a true Federal/State partnership with ACF to help administer and promote the program.  The current PARIS board members come from Michigan, Connecticut, Oklahoma, New York, Utah, and Washington.  ACF and the Board help manage the PARIS website, promote usage, and encourage State enrollment.

 

How Does Workers’ Compensation Data Help Public Assistance Programs through PARIS?

 

There are numerous advantages for Public Assistance Agencies submitting workers’ compensation case data to PARIS:

 

• Workers’ compensation should be the Primary Payer-
• Wage replacement benefits are often higher than public assistance payments/ eligibility levels
• Dual Payment of Medical benefits (including pharmaceuticals) may be discovered
• Many workers’ compensation pensioners move out of State-
• Approximately 5375 pensioners from Washington (with valid SSN) lived out of State as of March 2007
• Many workers’ compensation claimants move out of State while still receiving benefits-
• Approximately 2200 per quarter from Washington State (with valid SSN)
• It is difficult to track what someone does once they cross State lines

How Would PARIS Help State Workers’ Compensation Programs?

 

State workers’ compensation systems will benefit from participation in PARIS in numerous ways. They will be able to:

 

• Identify workers claiming workers’ compensation benefits in more than one State
• Identify claimants receiving other types of Public Assistance in addition to workers’ compensation
• Identify claimants who have moved out of State
• Provide improved dependent information including marital status
• Help identify claimants who may have committed TANF fraud
• Help identify fugitive felons and certain other types of felons (including drug felons)

 

Who is Eligible for Adding Workers’ Compensation Data to their PARIS Match?

 

Only States with government run workers’ compensation programs are eligible to participate in PARIS.  State workers’ compensation systems are generally one of three types:

• Exclusive State fund systems where workers’ compensation must be purchased through the State (or through State authorized self-insurance arrangements with large companies that provide their own workers’ compensation insurance for their workers)
• Competitive systems where the State fund program competes in the open market with private workers’ compensation insurers.  In most competitive systems the State also acts as the insurer of last resort for companies unable to get insurance from a private carriers.
• States with no State fund that rely entirely on private insurance carriers to provide workers’ compensation coverage

 

List of States by type of workers’ compensation system:

Type of Fund	Jurisdictions	Suitable for PARIS Matching
Exclusive State Fund	North Dakota, Ohio, Puerto Rico, Virgin Islands, Washington, West Virginia*, Wyoming	Yes
Competitive System	Arizona, California, Colorado, Hawaii, Idaho, Kentucky, Louisiana, Maine, Maryland, Minnesota, Missouri, Montana, New Mexico, New York, Oklahoma, Oregon, Pennsylvania, Rhode Island, Texas, Utah	Probably
No State Fund	Alabama, Alaska, Arkansas, Connecticut, Delaware, District of Columbia, Florida, Georgia, Illinois, Indiana, Iowa, Kansas, Massachusetts, Michigan, Mississippi, Nebraska, Nevada, New Hampshire, New Jersey, North Carolina, South Carolina, South Dakota, Tennessee, Vermont, Virginia, Wisconsin	No

*Current as of July 1, 2008

How Will The Match Be Done?

 

There are several key factors for States that wish to add and utilize workers’ compensation data through the PARIS data exchange:

 

1. States may add workers’ compensation data during any quarterly PARIS match.
2. States providing workers’ compensation data must work with their own designated PARIS State Public Assistance Agency (SPAA) to ensure only one entity in each State is submitting PARIS data through the established “Connect:Direct” process
3. States should only submit active cases.
4. Each State submitting workers’ compensation data must identify a point of contact in their State to provide additional information if a match occurs if different from the   contact person listed on the PARIS Website.
5. If a match occurs, all matching jurisdictions would receive matching data from the other jurisdiction’s input records for review

 

Some of the basic data elements included in the match are

 

1.  Client’s Social Security Number (The key indicator in the PARIS match)
2.  Client’s Name Information
3.  Client’s Date of Birth
4.  State Postal Code
5.  Client’s Address Information
6.  Gender   (M=Male, F=Female)
7.  Marital Status
    (M=Married, S=Single, W=Widow/Widower, D=Divorced)
8.  Number of Dependents claimed
9.  Information specific to the different benefit types including
    eligibility start and end dates and payment levels

 

For a complete list of PARIS data elements please go to the PARIS web site located at: http://www.acf.hhs.gov/programs/paris/sys_info/PARIS_State_Input_Record_Format_New.html

 

Summary of Key Concepts Concerning the Addition of Workers’ Compensation Data to PARIS

 

• You must work with the SPAA in your State to participate
• A list of PARIS contacts by State is located at: http://www.acf.hhs.gov/programs/paris/state_info/state_par.html
• The PARIS Website is located at www.acf.hhs.gov/paris
• Should you have technical questions on this format, Howie Wheeler and David Russell, members of the PARIS Board of Directors (and responsible for coding issues) will address any questions you have.  They can be reached respectively at: howard.wheeler@ct.gov and russelld3@michigan.gov