Presentation on theme: "WHT/082311 Fighting Fraud, Waste and Abuse with Cross-Jurisdiction Contributory Systems Monty Faidley, Director of Market Planning Proprietary and Confidential."— Presentation transcript:
WHT/082311 Fighting Fraud, Waste and Abuse with Cross-Jurisdiction Contributory Systems Monty Faidley, Director of Market Planning Proprietary and Confidential
WHT/082311 2 Government Benefits Programs Impact Everyone 2 108,592,000 people receiving benefits in the United States $1.8 Trillion annual cost Estimated $90 Billion in Improper Payments Key Issue: Reducing Fraud, Waste, and Abuse
WHT/082311 What is a Contributory System 3 Shared pool providing insights Similar stakeholders contributing similar information Agreed upon usage rules Adding one source gives immediate benefit to all participants To get, you must give Give a little, Get a lot
WHT/082311 Contributory System: An Inter-Agency Example 6 Agency Sources IDENTITY DATA J. Simmons Miami, FL 33109 72 East 3 rd St Name: Address: Address 2: XXX-55-5555SSN: IDENTITY DATA Jack Simon 33109 72 E Third Name: Address: Address 2: -5555SSN: IDENTITY DATA Jackson Simons Miami, FL 40 W. Main Ave Name: Address: Address 2: XXX-55-5554SSN: DOR DMV HHS Consolidated IDENTITY DATA Jackson 72 East 3 rd Street Simmons First: Last: Address: MiamiCity: FL, 33109 05/14/1972 XXX-55-5555 State/Zip: SSN: DOB: 1234567DL #: Simmons Inc. JS@Simmons.net (999) 999-9999 Company: Phone: E-mail: Single View of Identity Information Across the State Services Identity Proofing Risk Assessment Information Exchange No Yes Deceased: Incarc: Resident: No Corrected
WHT/082311 Contributory System Benefits in Fraud, Waste, and Abuse 7 Improve Program Integrity Identify known high risk activities and individuals Verify and authenticate identity information in online transactions Resolve information across agencies Improve Decision Timeliness Required information is available at your fingertips Updated in real time or near real time Improve Accuracy Identify relevant, reliable information that improves decision-making Verify eligibility information before determination is made
WHT/082311 Contributory Systems: Common Challenges 8 Who owns the data? What are the Department regulations on data usage? Data sharing? What are your State laws governing data sharing and privacy? What Federal Regulations for data sharing exist that impact your Agency? Legal and Regulatory Issues Clearly define Permissible Use – “Who is allowed to access this information?” Clearly define Permissible Purpose – “What are they allowed to do with this information?” Work closely with Policy, Regulators, and Lawmakers Best Practices
WHT/082311 Contributory Systems: Common Challenges 9 Does your application process include permission to use an individuals data for this purpose? How will the system be viewed by individuals? The press? The ACLU? How do you minimize sharing of Personally Identifiable Information (PII)? Privacy Identify ways to secure individual approval through language on applications or online click-through Provide an opt-in / opt-out function for individuals Avoid terms like “profiling”, “dossiers”, “surveillance”, or “total information awareness” Best Practices
WHT/082311 Contributory Systems: Common Challenges 10 Security Track, Report, and Audit data access at the data element layer Follow federal and industry best practices for physical, network, and server security. Patch often! Limit access, at the data element layer, to a need-to-know basis Best Practices What is the risk of storing contributed data in a single place? Who owns the liability for a data breach? Is your cyber security up to the task?
WHT/082311 Contributory Systems: Common Challenges 11 How big will this system grow? Can it handle millions of records? Billions? Trillions? How do you securely contribute data to the system? How do you secure access to the data? How do you track, audit, and report on compliance? Technical Implications Use proven solutions and platforms Leverage cloud-based technology Use open source where possible Follow industry standards Best Practices
WHT/082311 Starting a Contributory Project 12 Where Do I Begin? Create a Vision – what problem do you want to solve? Start Networking – build a team of stakeholders Seek out Industry Partners with contributory experience Pick a Leader Look to the Future - accept that the process will take time
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