Do Not Pay Business Center Jenny Rone Director, Outreach & Business Processes January 2015 A New Day for Do Not Pay 2014 Transformation • Two major releases within the last few months • A new architecture provides: An improved user interface Increased efficiency • More substantive data sets continue to be incorporated - significantly increasing the ability to identify potential improper payments Page 2 LEAD ∙ TRANSFORM ∙ DELIVER Brookings Institute Top 10 Tech Innovations That Will Transform Society and Governance “New technologies can have revolutionary impacts with widespread and unexpected benefits. Technology can also serve as a tool to enable governments to better serve their citizens.” #8 – Do Not Pay Portal 12/22/14 Page 3 LEAD ∙ TRANSFORM ∙ DELIVER Do Not Pay (DNP) is… A multi-functional analytics tool and one-stop data shop built to help federal agencies detect and prevent improper payments Page 4 LEAD ∙ TRANSFORM ∙ DELIVER DNP’s Mission is to… • Help prevent, reduce, and stop improper payments while protecting citizens’ privacy • Partner with agencies to identify potential fraud, waste, and abuse in federally funded programs while protecting citizens’ privacy Page 5 LEAD ∙ TRANSFORM ∙ DELIVER Improper Payments – the basics $106 billion in improper payments issued in FY 2013 The Problem Page 6 All improper payments degrade the integrity of government programs Reducing improper payments is a top priority Not all improper payments represent a loss to the government and not all improper payments are fraudulent LEAD ∙ TRANSFORM ∙ DELIVER Improper Payments – what, how, and why What? – Payments made to the wrong entity, in the wrong amount, or for the wrong reason Why? – • Documentation and Administrative Errors • Authentication and Medical Necessity Errors • Verification Errors Page 7 LEAD ∙ TRANSFORM ∙ DELIVER Improper Payments Legislation & DNP Page 8 LEAD ∙ TRANSFORM ∙ DELIVER DNP – A Tool in an Agency’s Toolbox $106 billion in improper payments issued in FY 2013 The Problem Page 9 (part of) The Solution LEAD ∙ TRANSFORM ∙ DELIVER DNP Built on a Strong Foundation People Governance DNP Program Technology Page 10 LEAD ∙ TRANSFORM ∙ DELIVER Data It’s a Partnership - DNP Role and Responsibility • Provide a centralized system that agencies can use to determine whether a payment is proper or improper – one which is committed to providing: • more and better quality data • continuous system development • service enhancements • DNP does not: • inform an agency whether a payment is proper or improper • stop payments UNLESS they are approved/established in conjunction with agency Page 11 LEAD ∙ TRANSFORM ∙ DELIVER It’s a Partnership – Federal Agency Federal Agency Role and Responsibility • Adjudication - the process by which agencies review the results of matches received from DNP and determine whether a payment is proper or improper. • Determination of “proper vs. improper” are made consistent with existing laws, regulations, and guidance related to those particular payments. • Agencies can work with DNP to establish business and stop payment rules. Page 12 LEAD ∙ TRANSFORM ∙ DELIVER Breaking it Down One-stop Data Shop VS. Many Sources - Many Datasets One Source – Many Datasets Death – SSA Excluded Parties – GSA, HHS Credit – SBA, VA, DOJ, HUD, USDA, Ed Debt – Treasury Foreign Asset Control - Treasury Incarceration – SSA Do Not Pay Verification Records System of Records Notice – 01/14 Page 13 LEAD ∙ TRANSFORM ∙ DELIVER Breaking it Down Multi-functional Analytics Tool One tool supporting an agency’s business processes and financial management controls Payment Integration Continuous Monitoring Batch Matching Single On Line Search Advanced Analytics Page 14 LEAD ∙ TRANSFORM ∙ DELIVER DNP throughout the Payment Lifecycle On-line single search Batch Matching Continuous Monitoring Pre-award Pre-payment • Verify award eligibility • Re-verify or monitor eligibility for payments • Research matches Post-payment • Analyze data and trends • Conduct reporting • Implement corrective action At Time of Payment • Review matches from payment integration Payment Integration Agency Adjudication Advanced Analytics Page 15 On-line single search Batch Matching Continuous Monitoring LEAD ∙ TRANSFORM ∙ DELIVER At Time of Payment Payment Integration 4. Payment Integration Helping agencies seamlessly comply with IPERIA DNP, at time of payment, performs matches against the: Death Master File (DMF)-Public includes Social Security Number, Name, Date of Death, Date of Birth, Verified or Proof Indicator System for Award Management (SAM)-Exclusion RecordsRestricted includes exact name, DUNS, TIN, full address and information about debarment Page 16 LEAD ∙ TRANSFORM ∙ DELIVER Agency Adjudication Process Determine and identify “proper” or “improper” Ensure alignment with existing process and mission DNP identifies conclusive, probable and possible matches 8 2 7 Investigate further, confirm matches & document decision DNP suggests the following steps to successful adjudication 3 6 Prioritize critical matches 5 Apply applicable rules Page 17 Agency notified of matches and logs onto portal 1 4 Research internal business rules that apply to matches LEAD ∙ TRANSFORM ∙ DELIVER OMB Circular No. A-136 Financial Reporting Requirements X. Agency reduction of improper payments with the Do Not Pay Initiative. Page 18 LEAD ∙ TRANSFORM ∙ DELIVER Pre-Award / Pre-Payment Helping agencies verify eligibility through the DNP Portal 4. Payment Integration Single On Line Search Batch Matching Continuous Monitoring One-off search to verify eligibility up front or further research a match identified during payment integration Verify eligibility up front for a group (e.g., potential grant recipients) Monitor eligibility for a group that receives recurring payments (e.g., approved vendor list) Agencies Adjudicate Matches from these activities too….. Page 19 LEAD ∙ TRANSFORM ∙ DELIVER Currently Available through the Portal • Death Master File (DMF) Public [SSA] • List of Excluded Individuals & Entities (LEIE) Public [HHS] • Office of Foreign Assets Control (OFAC) Public [Treasury] • System for Award Management (SAM) Exclusion Records Public & Restricted [GSA] • SAM Entity Registration Records Restricted [GSA] • Treasury’s Offset Program (TOP) Debt Check Restricted [Treasury] • Credit Alert System or Credit Alert Interactive Voice Response System (CAIVRS) Restricted [SBA] Page 20 LEAD ∙ TRANSFORM ∙ DELIVER Availability Pending through the Portal • CAIVRS Restricted [VA, DOJ, Education, HUD, USDA] • List of Excluded Individuals & Entities (LEIE) Restricted [HHS] • Prisoner Update Processing System (PUPS) Restricted [SSA] Page 21 LEAD ∙ TRANSFORM ∙ DELIVER Public vs. Restricted – Let’s Talk CMA Computer Matching Agreements must be established for…. any computerized comparison of two or more automated systems of records or a system of records with nonFederal records for the purpose of establishing or verifying the eligibility of, or continuing compliance with, statutory and regulatory requirements by, applicants for, recipients or beneficiaries of, participants in, or providers of services with respect to cash or in-kind assistance or payments under federal benefit programs Page 22 LEAD ∙ TRANSFORM ∙ DELIVER CMAs are NOT Required for… • Single On Line searches • Statistical matches • Matching program between public data sources or those not aligned to a system of records • Matching programs that do not involve verifying eligibility in a Federal benefit program – Example: When the purpose of the match is to make procurement decisions • Payment Integration (Treasury handles this for you in the payment stream) Page 23 LEAD ∙ TRANSFORM ∙ DELIVER CMA Triggers • Matching against data sources with personally identifiable information (PII) on U.S. citizens; deceased are not covered by Privacy Act • Typically, only Federal benefit programs providing cash or in-kind assistance to individuals are covered • Presently, only batch and continuous monitoring users will need CMAs to match against restricted sources within Treasury’s Working System Page 24 LEAD ∙ TRANSFORM ∙ DELIVER DNP and CMAs Two Important Documents Office of Management and Budget OMB M-13-20, Protecting Privacy while Reducing Improper Payments with the Do Not Pay Initiative Do Not Pay Verification Records System of Records Notice (SORN #.023) JAN 2014 Enables DNP to derive data and retain records, and enter into CMAs Page 25 LEAD ∙ TRANSFORM ∙ DELIVER CMA Process – OMB M-13-20 • Highlights of OMB M-13-20, Protecting Privacy while Reducing Improper Payments with the Do Not Pay Initiative: Topic Excerpt CMA Lifespan Matching programs have a termination date of less than three years. Agencies may renew these CMAs for a maximum of three years. Review Period Data Integrity Boards (DIBs) have a 60-day deadline for review of a CMA. If circumstances do not permit the DIB to approve or disapprove the DNP matching program within 60 days, the DIB shall provide a brief memorandum to the head of the agency (or to the Inspector General in cases where the Inspector General proposed the matching program) describing the necessity for the delay. Cost Benefit Agencies' cost-benefit analyses for a DNP matching program need Analysis not contain a specific estimate of any savings. Page 26 LEAD ∙ TRANSFORM ∙ DELIVER Typical CMA Process without DNP SORN CMA GSA CMA Treas Federal Agency Page 27 CMA HHS LEAD ∙ TRANSFORM ∙ DELIVER CMA Process with DNP SORN CMA DNP Federal Agency Page 28 LEAD ∙ TRANSFORM ∙ DELIVER M-13-20 & Data Analytics “…Treasury's Working System includes Treasury's system of records for Do Not Pay, as well as other activities such as investigation activities for fraud and systemic improper payments detection through analytic technologies and other techniques…” Page 29 LEAD ∙ TRANSFORM ∙ DELIVER Page 30 3 2 1 4 Level Level Payment Data (validated; disbursed; post-payment) Data source shared with Payment Management LEAD ∙ TRANSFORM ∙ DELIVER Data Sources Demographic Data Financial Data Matching agency payment data against data sources using program-specific business rules Agency Data Analyzing matching trends within and across agencies Eligibility Data Identifying specific and generalized scenarios Level Creating and executing predictive models Level Moving on – Advanced Analytics Adjudication Advanced Analytics Assembling Data into Information and Information into Insight Page 31 Risk Analysis LEAD ∙ TRANSFORM ∙ DELIVER Business Process Mapping Helping to strengthen Government-wide Financial Management Controls on Payments • In-depth examination of the entire payment disbursement system • Components examined include program’s objectives, target beneficiaries, eligibility requirements, awarding criteria, and verification processes • Resulting in development of: • improved improper payment detection methods • business rules and/or stop payment rules Page 32 LEAD ∙ TRANSFORM ∙ DELIVER But I Have a Pre-award/Payment Process GREAT!!!! With DNP you have…. Page 33 LEAD ∙ TRANSFORM ∙ DELIVER Agencies Are Having Success Identifying payments to be stopped or recovered Preventing future improper payments Page 34 LEAD ∙ TRANSFORM ∙ DELIVER Contact Information visit us at: www.donotpay.treas.gov Want to Learn More? Sign up for our mailing list to receive updates on new functionality and data sources or to schedule a demo. http://www.donotpay.treas.gov/MailingList.htm 1-855-837-4391 donotpay@stls.frb.org DNP Executive Director: Kevin.Jones@fiscal.treasury.gov DNP Director of Outreach & Bus. Processes: Virginia.Rone@fiscal.treasury.gov Page 35 LEAD ∙ TRANSFORM ∙ DELIVER 202-504-3516 202-874-6185