Eligibility Verification Could Save Billions in Improper Federal Benefit Payments

MITRE Announces Payment Integrity Challenge Winner, Citizen Wallet concept by SAP, which could improve federal agencies’ ability to verify applicant eligibility for benefit payments.

Article ID: 709545

Released: 13-Mar-2019 4:00 PM EDT

Source Newsroom: MITRE

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    Credit: Jae Robinson for MITRE

    MITRE Challenge winner Team SAP presented their Citizen Wallet concept to government and industry representatives at today’s “Next Gen Approaches to Strengthening Payment Integrity” event on MITRE’s campus in McLean, Va.

Newswise — MCLEAN, Va., and BEDFORD, Mass., March 13, 2019 – Twenty-nine industry and university teams accepted the MITRE Challenge: Strengthening Eligibility Verification for Federal Benefits Programs, contributing unique and innovative ideas to reduce improper government payments, but only one was selected to receive the $50,000 grand prize. Team SAP presented their benefits eligibility verification concept, ‘Citizen Wallet,’ to representatives from government agencies and industry at today’s “Next Gen Approaches to Strengthening Payment Integrity” event at MITRE’s McLean, Va., campus. Team SAP’s winning recommendation included empowering individuals to create an account and choosing to import information about themselves already available in authoritative government data profiles. Three other finalists received $5,000 each: Team Converus/AML Partners, Team Proper Bobcats from Texas State University, and Team SAS.

Applicant fraud or inadequate verification of eligibility to receive funds from many federal programs result in the improper payment of billions of dollars annually. An estimated 25 percent of the nearly $141 billion in 2017 improper payments occurred because agencies did not verify with certainty that the individuals paid were eligible. To highlight the importance of this problem, the 2018 President’s Management Agenda included “Getting Payments Right” as a cross-agency priority (CAP) goal to coordinate government efforts at overcoming this problem. This year’s MITRE Challenge was developed in support of its government sponsors to find new approaches to solving improper payments – those that should not have been made or were made in the wrong amount.

“Ensuring the right person or entity receives the right payment at the right time is a high priority for government agencies because even a slight reduction in improper payments produces enormous savings,” said Jay Schnitzer, MD, MITRE’s chief technology officer. “The MITRE Challenge allows industry and academia to think differently about some of the nation’s toughest problems and share potential solutions with federal agencies. We congratulate all of the participants and look forward to seeing how their recommendations advance the goal of eliminating waste, fraud, and abuse in government payments.”

Today’s Payment Integrity event included a discussion of the “Getting Payments Right” CAP goal from the Office of Management and Budget (OMB) and interagency work groups, a panel on identity-related aspects of Payment Integrity, and presentations from the MITRE Challenge finalists. The event concluded with OMB and MITRE leading a discussion with attendees on how insights and ideas generated today can be folded into activities by the CAP goal work groups, individual agencies, the private sector, and academia to help address this national issue.

MITRE hosts challenges to engage with and incentivize industry and academia to apply innovative technologies, business practices, and research findings to important challenges facing government. Prior challenges have focused on multicultural name matching, countering Unmanned Aircraft Systems, and identifying Internet of Things devices.

Finalist Proposals

Team SAP

The SAP Citizen Wallet concept would allow individuals to create an account, choose the programs in which they want to be enrolled, and select a contact method (text/app notification/ phone /website/ mail) and frequency (weekly/monthly/annual). The concept will automatically validate eligibility each month, notify beneficiaries of their current eligibility status, and notify agency staff when additional clarification is needed.

Team Proper Bobcats The Trusted Applicant Program concept is a continuous pre-payment, risk-based data verification framework that provides enhanced vetting using predictive analytical methods, such as Probabilistic Variable Accuracy and Facial Recognition algorithms. The core strength of the concept comes from the assumption of ineligibility unless otherwise documented; this extends the definition of applicant to all members of the household and makes the applicants an active component of the eligibility checks while using advanced analytics.

Team Converus/AML Partners

Objective Eligibility Verification technology leverages new RegTech-platform technology, cutting-edge identity-resolution methods, Application Program Interface (API) technologies, and blockchain advancements. This concept would allow government agencies to create a shared network of applications unique to their proper-payment needs; an ecosystem of eligibility data accessible across agencies; and a ground-truth digital identity and benefits profile for each beneficiary that may be stored, updated, and accessed via blockchain as needed and with full certitude.

Team SAS

Taking a “recipient-centric needs based” approach, as compared to a “verifying eligibility per benefit program” approach, this concept involves an open, interoperable analytic platform strategy that provides a social benefit program office the ability to (1) access data from virtually any available source, hardware platform, operating system, or data format, (2) instill governance, and (3) operationalize the creation of analytically ready data environments that can be used for risk modeling and automated alerting based on “life changes” events. 

About MITRE

MITRE's mission-driven teams are dedicated to solving problems for a safer world. Through public-private partnership as well as the operation of federally funded R&D centers, we work across government to tackle challenges to the safety, stability, and well-being of our nation. Learn more about The MITRE Challenge at mitre.org.

Contact: Mike Murphy

mdmurphy@mitre.org

781-271-7284

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