| Abstrakt: |
Fraud, waste, and abuse losses are major challenges for entitlement programs. Because these programs constitute a large part of the government's annual budget, even a small percentage of fraud, waste, and abuse results in staggering losses. The "Improper Payments Information Act of 2002" (PL 107-300) requires agencies to assess the risks of making improper payments. This includes a statistically valid determination of the amount of improper payments in their programs, identification of the root causes, a plan to reduce improper payments in those programs that are deemed vulnerable, and an annual report to identify the risks and reduction methods. This paper addresses strategies for mitigating risk of improper payments through identity authentication and eligibility assessment. While this paper focuses solely on applying risk assessment strategies, it is anticipated that future white papers will focus on internal controls (solutions), and the recovery process. Anecdotal and pilot test data are presented to illustrate the identity challenges that facilitate improper payments. Proven risk assessment and management methods are presented to demonstrate how they can mitigate eligibility and entitlement weaknesses. An information based identity authentication system solution is recommended to combat improper payments where identity fraud/theft, at both the enrollment and post award stages, is a root cause. There is considerable concern that individuals who do not meet the eligibility criteria are receiving entitlement benefits. This may be due to several reasons, including misrepresentation of financial information, identity fraud and theft, account takeover, and misallocation of funds. For example, data mismanagement results in misallocations of funds, which creates opportunities for fraud and abuse that otherwise would not have existed. This paper suggests a methodology for improving on eligibility assessment in the enrollment phase and in post award analysis. [ABSTRACT FROM AUTHOR] |
